Health Care Seeking Behaviour and Expenditure for Childhood Illness in Coastal District of India-A Community Based Study

Abstract

Introduction: Delay in access to health care involves problem in disease recognition, decision making and availability of health services. Health Care Seeking Behaviour (HCSB) is an important component of Health Systems Research (HSR) which is necessary for planning child health policies. Escalating health care expenditure and inaccessibility to health care facilities have been identified as major deterrent to seek health. Aim: To study: 1) HCSB of mothers for childhood illness; 2) Source of healthcare sought and expenditure incurred. Materials and Methods: Cross sectional community based study among representative sample of mothers of under 5 (U5), 1980 mothers from Dakshina Kannada district were interviewed and 431 reported illness. HCSB was predefined by 'Appropriate care', 'Appropriate and prompt care' and 'prompt care'. Health expenditure incurred was studied in various income groups. Results: Illness episodes were reported in 431 (22.6%) out of 1903 mothers. 'Appropriate and Prompt care’ was given by 388 (90.02%) and most mothers interviewed were aware of danger signs. Private Health Care System (PHCS) was preferred by most, but expensive (Rs. 514.5) than Public Health System (PHS) (Rs. 236) per illness episode. Of 262 people with income less than 1000, 32(12.2%) did not have BPL card. Conclusion: Significant percentage of families with monthly income < Rs.1000 do not have BPL cards thereby deprived of benefits, contributing to “impoverished care”. Most mothers were aware of danger signs and health services were available within short distances, indicating good accessibility to healthcare. Most mothers (90.02%) sought prompt and appropriate care irrespective of economic status, literacy, occupation, parity and distance from health provider.