Using Q-methodology to explore people’s health seeking behavior and perception of the quality of primary care services

Nazar P Shabila,Tariq S Al-Hadithi,Egbert Sondorp,Namir G Al-Tawil

doi:10.1186/1471-2458-14-2

Abstract

BackgroundInformation on health seeking behavior and beneficiaries’ perception of the quality of primary care can help policy makers to set strategies to improve health system. With scarcity of research on this particular field in Iraqi Kurdistan region, we sought to explore the patterns of health seeking behavior and perception of the quality of primary care services of a sample of population.MethodsThis explorative study was carried out in Erbil governorate, Iraq. Data were collected using the novel approach of Q-methodology for eliciting subjective viewpoints and identifying shared patterns among individuals. Forty persons representing different demographic and socioeconomic groups and living in different areas of Erbil governorate sorted 50 statements reflecting different aspects of health-seeking behavior and primary care services into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis through centroid factor extraction and varimax rotation of factors were used to derive latent viewpoints.ResultsFour distinct patterns of health seeking behavior and viewpoints toward the primary care services were identified. People in factor 1 are extremely critical of the services at primary health care centers and are regular users of the private health sector. People in factor 2 positively recognize the services at primary health care centers but mainly turn to inappropriate health seeking behavior. People in factor 3 have satisfaction with the services at primary health care centers with minimal use of these services, but mainly turn to the private sector. People in factor 4 are slightly satisfied with the services at primary health care centers but mainly rely on these services.ConclusionsThis study highlighted the typical characterizations that were associated with each uncovered factor. Informing on the beneficiaries’ concerns about the primary care services can help to improve the system through further exploring the issues raised by the respondents and directing particular action on these issues. The characterizing and distinguishing statements can be used as a set of questions to conduct community-based survey on this important aspect of health services.

Highlights

Information on health seeking behavior and beneficiaries’ perception of the quality of primary care can help policy makers to set strategies to improve health system
Due to limited research evidence in this particular field in Iraq in Kurdistan region, we sought to explore the patterns of health seeking behavior and perception of the quality of primary care services of a sample of Iraqi population using the novel approach of Q-methodology
This study identified four distinct patterns of study participants’ health seeking behavior and perception toward the quality of primary care services

Summary

Introduction

Information on health seeking behavior and beneficiaries’ perception of the quality of primary care can help policy makers to set strategies to improve health system. With scarcity of research on this particular field in Iraqi Kurdistan region, we sought to explore the patterns of health seeking behavior and perception of the quality of primary care services of a sample of population. Primary care constitutes an entry point into health services where a wide range of curative and preventive health care services are delivered. The private health sector provides mainly curative health services through private clinics and pharmacies. The Iraqi health care system its primary care component, was seriously affected by wars, internal conflicts, economic sanctions and political instability over the last few decades [6,7]

Methods

Results

Discussion

Conclusion