Spatiotemporal analysis of having been sick or injured and having sought health consultation by district in Punjab province of Pakistan - 2010-2015.

Abstract

To analyse the geospatial and temporal distribution of disease and injury burden and factors that influence health care seeking behaviour in thirty-six districts of Punjab in Pakistan. Utilizing the district level-Pakistan Social and Living Standards Measurement survey data for 2010-2015 from the Pakistan Bureau of Statistics and Human Development Index (HDI) data for the years 2011-2015 from the United Nations Development Programme; choropleth maps were created based on the district level proportions of population reporting having been sick or injured and having sought health consultations for all three waves of PSLM surveys and based on HDI for the years 2011, 2013 and 2015 for the Punjab districts. Spatial cluster analysis of having been sick or injured and having sought health consultations for three waves of PSLM was conducted. For the years (2010-11), (2012-13) and (2014-15) respectively; the mean proportions of population that reported being sick or injured were (7.36±2.23), (6.99±2.33), and (5.70±1.72). The corresponding mean proportions that sought health consultation were (96.11±2.92), (96.05±2.26) and (96.82±2.15) respectively. Having sought health consultation in years (2010-11) and (2012-13), having been sick/injured in (2010-11), and human development index of 2013 as well as 2015 were statistically significant determinants of having sought consultation in the last wave of (2014-15) (p<0.05). Findings show a decline in the reported disease and injury burden between 2010 and 2015 but constant rates of seeking health care. HDI and having sought care previously are the major determinants of subsequent health consultation in Punjab. Future studies need to focus on how these results can be utilized to health inequalities in Pakistan.