Determinants Of Healthcare-seeking Behaviour Research Articles

Social Health Insurance and Healthcare Seeking Behavior in Urban Ethiopia.

After years of planning, in 2024 the government of Ethiopia proposes to introduce a compulsory Social Health Insurance (SHI) program for formal sector employees. The proposed scheme will provide access to contracted healthcare facilities at a premium of 3% of the gross monthly income of employees with another 3% coming from the employer. Several studies have examined the willingness to pay (WTP) this premium, however, little is known about the healthcare seeking behavior (HSB) of formal sector employees. This paper investigates both - the determinants of healthcare seeking behavior and among other aspects, WTP the premium. Through these explorations, the paper sheds light on the potential challenges for implementation of SHI. Descriptive statistics, logit, and multinomial logit (MNL) models are used to analyze retrospective survey data (2,749 formal sector employees) which covers the major regions of the country. Regarding outpatient care, a majority of the visits (55.9%) were to private healthcare providers. In the case of inpatient care, it was the opposite with a majority of healthcare seekers visiting public sector hospitals (62.5%). A majority of the sample (67%) supported the introduction of SHI but only 24% were willing to pay the proposed SHI premium. The average WTP was 1.6% of gross monthly income. Respondents in the two richest income quintiles were more likely to oppose SHI and consider it unfair. The prominent role of the private sector and the resistance to SHI amongst the two richest income quintiles, suggests that the SHI program needs to actively include private healthcare facilities within its ambit. Additionally, concerted efforts at enhancing the quality of care available at public health facilities, both, in terms of perception and patient-centered care and addressing drug and equipment availability bottlenecks, are needed, if SHI is to garner wider support.

Morbidity Patterns and Determinants of Healthcare-Seeking Behavior Among Older Women in Selected Rural Areas of Bangladesh

BackgroundBangladesh has experienced growth in the older population in number and proportion, owing to a decline in fertility and mortality, and an increase in life expectancy. Older women in rural Bangladesh have considerably poorer health status than older men, because of women’s’ higher life expectancy and extreme vulnerability as a result of socioeconomic marginalization.ObjectivesThe purpose of the current study was to explore the morbidity patterns and healthcare-seeking behaviors, and their determinants, among older women in selected rural areas of the Bagerhat District in Bangladesh, and to provide recommendations for potential future interventions in this context.Material and MethodsA cross-sectional study was conducted at the household level. Data were collected from 233 randomly selected older women ≥ 60 years of age in three selected villages in the Bagerhat district in Bangladesh in November 2021. Univariate and bivariate analyses (Chi-squared test) were applied to explore morbidities and the associations of healthcare-seeking behaviors with various determinants. Multivariable logistic regression was applied to identify the associations between healthcare-seeking behavior and significant determinants extracted from the bivariate analysis.ResultsDiabetes and liver diseases were the most common morbidities among older women. Multivariable logistic regression analysis indicated that education, living arrangement, size of the family, and morbidity patterns were significantly associated with seeking healthcare services among older women in rural Bangladesh (P ≤ 0.05). The rates of seeking healthcare services were higher among older women with primary and secondary education, those living with spouses and children, those residing in extended families with seven or more members, and older women with diabetes and liver diseases.ConclusionOn the basis of the findings, we suggest that the traditional extended family structure should be sustained, wherein older people are treated with care and respect, thereby promoting healthy aging in rural Bangladesh. Furthermore, family relationships should be strengthened, because older individuals, particularly older women, require emotional and familial support to lead healthy lives. Because gender roles, norms, and relationships influence people’s exposure to disease, awareness programs regarding the prevalence of morbidities in old age, particularly among older women, should be expanded in rural areas to achieve Sustainable Development Goal 3.

Determinants of Rural Women’ Healthcare Behavior in Khyber Pakhtunkhwa, Pakistan

Current study has examined the determinants of healthcare seeking behaviour of rural women in Khyber Pakhtunkhwa province of Pakistan. For this, data were collected from 178 respondents using a questionnaire and key informants interviews i.e. lady health workers (10) and doctors (10). For data analysis, descriptive statistics and thematic analysis were used. It was found that majority of the respondents did not sought immediate healthcare. Various themes have been identified through thematic analysis such as social, cultural and economic factors which influence healthcare seeking behavior of rural women in the study area. Social factors included gender and patriarchy, while restricted mobility, low educational status, and non-preference of women healthcare needs were encompassed by cultural factors. Economic factors comprised of affordability and availability of transportation. Therefore, appropriate and long term planning and execution from the formal health care system of the province in the light of current study findings are suggested.

Health-Care Seeking Pathways Of Psychiatry Patients In North Karnataka of India - A Hospital-Based: Exploratory Cross-Sectional Study

INTRODUCTION: Neuropsychiatric disorders contribute for 13% of the total morbidities globally. In 2017, a study revealed that 14% of the Indian Population suffered from psychiatric health problems. The WHO estimates 2443 DALYs (Disability adjusted life years) per 100000 population in India due to psychiatric problems. The non-availability of mental health services, stigma, and superstitions associated with mental disorders, along with the unwillingness or inability of families to care for their mentally ill relatives, appear to be major cause behind delay in approaching a psychiatrist. These factors act as major barriers in the pathways of care for these patients, thereby increasing the unmet need. An understanding of the way people seek care for mental disorders is important for implementing mental health services, and developing effective referral mechanisms. Hence this study was taken up with the objectives. OBJECTIVEs: To determine health-care seeking pathways of psychiatry patients using WHO pathways of care proforma and to explore the social and cultural determinants of health-care seeking behaviour in them. METHODOLOGY: This exploratory cross-sectional study includes newly diagnosed psychiatry patients (ICD-10), visiting psychiatry OPD in a private medical college in Bagalkot, North Karnataka, India. Sample size for proportion was calculated to be 340 ~350, taking 33% as P (Pilot study) and at 5% absolute precision at 95% confidence level. Written Informed consent were obtained from the study participants or from the patient attenders, in case of inability to give informed consent. Predesigned and pretested proforma were used for obtaining socio-demographic details of subjects. Patients were examined and diagnosed by the Psychiatrist (Principal Investigator). World Health Organisation (WHO) pathways to care proforma were used to obtain the health-care seeking behaviour of these study subjects. Statistical analysis will be done using SPSS software version19 and appropriate statistical tests will be applied. RESULTS: In the pilot study, we observed that about 32% of patients firstly approached medical practitioners, followed by psychiatrists and faith healers. An average delay of 24 months was found in reaching psychiatric services. CONCLUSIONS: There is a substantial delay in health-care seeking of psychiatry patients to psychiatrist, as per the pilot study. Further completion of this study is required to understand the extent of the problem, and socio-cultural factors leading to such delay. Generating awareness among the general public to address cultural myths and stigma related to psychiatric illnesses is required

QUALITY OF HEALTH CARE SERVICE’S AND PROVIDER’S DETERMINANTS OF HEALTH CARE-SEEKING BEHAVIORS AMONG WOMEN IN KHANA LOCAL GOVERNMENT AREA OF RIVERS STATE, NIGERIA

<p>The study examined the quality of health care services and provider’s determinants of health care seeking behavior among women in Khana local government area of Rivers State. The study adopted a descriptive cross-sectional survey design. Three research questions and two hypotheses guided the study. The sample size for the study was 1,200 women selected using multi-stage sampling procedures. A validated self-structured instrument, titled, “Determinants of Health Care Seeking Behavior Questionnaire”, with a reliability index value of 0.64 was used for data collection. Means and Standard Deviations were used to answer the research questions whole Analysis of Variance was used to test the hypotheses at the 0.05 level of significance. The results of the study showed that the respondents had good health care-seeking behaviors in terms of action on perceived signs and symptoms of disease (= 2.67 + 0.89), test-seeking behavior (= 2.93 + 0.94), choice of health care service’s factors (= 3.36 + 0.76), treatment-seeking behaviors (= 2.86 + 0.95), and treatment-adherent behavior (= 2.87+ 0.85). The results also showed that quality of health care service (= 2.90 + 0.97) were significant determinants, while health care provider’s factors (= 2.43 + 1.05) were not determinants of health care seeking-behavior of the respondents. The study recommended among others that health care services should be health care consumers-centered to sustain and improve on the health care-seeking behavior and proper re-orientation of health care providers should be carried out at every level of health care in order to create friendly relationship between health care providers and consumers or patients.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0917/a.php" alt="Hit counter" /></p>

Demographic Determinants of Health Care-Seeking Behaviour among Women in Khana Local Government Area of Rivers State, Nigeria

The study investigated the demographic determinants of health care-seeking behaviour among women in Khana Local Government Area of Rivers State. Five research questions and one hypothesis guided the study. Descriptive cross-sectional design was adopted. The sample size of 1,200 women was selected using multi-stage sampling procedures. Self-structured instrument, whose reliability was determined using Cronbach Alpha Correlation was used for data collection. The study utilized statistical tools of Mean Standard deviation and one-way Analysis of Variance (ANOVA) to analyze the data. The result of the study showed that the respondents had good health care-seeking behaviour in terms of action on perceived signs and symptoms ( = 2.67 ± 0.89), test-seeking ( = 2.93 ± 0.94), choice of health care services ( = 3.36 ± 0.76), treatment-seeking ( = 2.86 ± 0.95), and treatment- adherence ( = 2.87 ± 0.85). The findings also showed that demographic factors of age (F=8.767, P < 0.000), occupation (F = 19.304, P < 0.000), educational level (F = 3.019, P < 0.029), and income level (F = 4.680, P < 0.003) were significant determinants of health care seeking behaviour of the women. The study recommended among others that women should be empowered more through educational and employment opportunities Keywords: Demographic Factors, and Health Care-Seeking Behaviour.

Determinants of Healthcare Utilisation for Foodborne Illness Among Students in Saudi Arabia: A Cross-Sectional Study.

Background:Understanding of healthcare utilisation during foodborne illness is vital for public health practice, and healthcare planning. Present study aims to identify patterns and determinants of healthcare-seeking behaviour in response to foodborne illness among students of Saudi Arabia.Methods:A cross-sectional survey was conducted among 252 students of Saudi Electronic University located in four major cities (Riyadh, Abha, Dammam and Jeddah) of Saudi Arabia. Study participants were students who reported a foodborne illness within 1 month prior to the survey. A multivariate logistic regression models were used to analyse association of healthcare-seeking behaviour with knowledge and attitude about food poisoning of participants.Results:Of the 252 participants who experienced foodborne illness symptoms, 69.8% visited doctor for seeking care, while 7.5% visited pharmacy, 9.1% got treated by the family and peers and 13.4% did not do anything. Healthcare-seeking behaviour of participant showed association with knowledge of the cause of food poisoning (AOR: 1.98; 95% CI 1.04-3.78, P = .036); and attitude of participant that food poisoning illnesses is a serious health problem and may lead to death (AOR: 2.15; 95% CI 1.33-2.71, P = .014).Conclusions:In this study, majority of the participants used healthcare for treatment during the food poisoning episode, and healthcare-seeking behaviour depended on perceived severity of the disease consequences. Knowledge on food poisoning was found to be an important determinant in utilisation of healthcare services. Health promotion and educational programmes are recommended to further increase the healthcare utilisation for foodborne illness.

Predisposing Factors and need Factors as Determinants of Health Care-seeking behavior of Pregnant Women in Uvwie, Delta, Nigeria

Predisposing Factors and need Factors as Determinants of Health Care-seeking behavior of Pregnant Women in Uvwie, Delta, Nigeria

Determinants of Healthcare-Seeking Behaviour of People Living with HIV and AIDS (PLWHA) in South-East, Nigeria

Determinants of Healthcare-Seeking Behaviour of People Living with HIV and AIDS (PLWHA) in South-East, Nigeria

Malaria related care-seeking-behaviour and expenditures in urban settings: A household survey in Ouagadougou, Burkina Faso

In Sub-Sahara Africa, malaria inflicts a high healthcare expenditure to individuals. However, little is known about healthcare expenditure to individual affected by malaria and determinants of healthcare seeking behaviour in urban settings where private sector is thriving. This study investigated the level and correlates of expenditure among individuals with self-reported malaria episode in Ouagadougou, Burkina Faso. A cross-sectional household survey conducted in August-November 2011 in Ouagadougou covered 8,243 individuals (1,600 households). Using Generalized Estimating Equations, the analysis included 1082 individuals from 715 households, who reported an episode of malaria. Of individuals surveyed, 38.3% sought care from public, 27.4% from private providers, and, 34.2% self-medicated. The median cost for malaria treatment was USD10.1 (4,850.0XOF) with significant different between public, private and self-medication (p<0.001). In public primary care health facilities, the median cost was USD8.4 (4,050.0XOF) for uncomplicated malaria and USD15.2 (7,333.5XOF) for severe malaria. In private-for-profit facilities run by a medical doctor, the median cost was USD30.3 (14,600.0XOF) for uncomplicated malaria and USD 43.0 (20,725.0XOF) for severe malaria. Regardless of the source of care, patients with insurance incurred significantly higher expenditure compared to those without insurance (p<0.001) and medicine accounted for the largest share of the expenditure. The type of provider, having insurance, and the severity of the malaria predict the amount of money spent. The high financial cost of malaria treatment regardless of the providers poses threat to the goal of universal access to malaria interventions, the unique way to achieve elimination goals.

Determinants of health care-seeking behaviour among individuals with malaria symptoms in Adami-Tullu Woreda

Determinants of health care-seeking behaviour among individuals with malaria symptoms in Adami-Tullu Woreda

Care Seeking and Treatment for Urinary Incontinence in a Diverse Population

We examined care seeking and treatment for urine leakage in the Boston Area Community Health Survey, a racially and ethnically diverse, community based study of urological and gynecological symptoms and their correlates. Boston Area Community Health Survey used a multistage, stratified cluster design to enroll 5,506 black, Hispanic and white adults. Subjects were 30 to 79 years old and residents of Boston, Massachusetts. Data were obtained during a 2-hour in home interview. Analyses for this report include the 331 women and 128 men who reported weekly incontinence, defined as urine leakage that occurred 1 or more times weekly in the last year. Of women 45% and 22% of men with weekly incontinence reported ever having sought care for it. Of those who sought care 60% reported receiving treatment and half of those who were treated continued to have daily leakage. Of treated women 50% and 40% of treated men reported moderate to great frustration with continued urine leakage. This study demonstrates that the majority of men and women who experience weekly urinary incontinence do not seek care for it, many who sought treatment believe that none was provided and many who received treatment continue to have troubling symptoms. The public should be educated to seek care for urine leakage, health care providers should take the initiative to ask their patients about urinary symptoms and more attention should be given to ensuring that, when treatment is given, it is appropriate and effective.

Prevalence, awareness and determinants of health care-seeking behaviour for urinary incontinence in Qatari women: a neglected problem?

Objectives: The aim of this study was to determine the prevalence, awareness and determinants of urinary incontinence (UI) among Qatari women and the sociodemographic factors involved in their health care-seeking behaviour. Design: A cross-sectional study was used to determine the symptoms of UI experienced by Arabian Gulf women. Setting: Primary Health Care (PHC) Centres and community-based study in Qatar. Subjects: A multistage sampling design was used and a representative sample of 1000 Qatari women aged 45 years and above were included from January to June 2003. Measurements: Participants completed a questionnaire assessing UI in the previous 12 months and health care-seeking behavior for urinary symptoms. Results: Of 1000 women living in urban and semiurban areas who were asked, 798 (79.8%), representing the study sample, agreed to participate and completed the questionnaire. Of these, 164 (20.6%) were found to have UI. Overall, the reason for not seeking medical attention was mainly embarrassment (40.6%) at having to speak with doctor. Of the total study sample, 562 subjects (70.4%) believed that UI was abnormal and worth reporting to a doctor. Coping mechanisms among incontinent women included frequent washing (58.3%) and wearing a protective perennial pad (42.4%), changing underwear frequently (41.3%), decreasing fluid intake (19.8%) and stopping all work (4.9%). Sufferers were most troubled by their inability to pray (64%) and their marital relationship (47%), limitation of their social activities (20%), difficulty in doing housework (14%) and inconvenience during shopping (13%). Most (71.9%) of the incontinent subjects were self-conscious, ashamed of themselves and troubled by guilt ( P < 0.001); 56% found it most embarrassing to discuss UI with their husbands. The majority of women (51.9%) believed child birth to be the major cause of UI, followed by ageing (49.5%), menopause (34.2%) and paralysis (25.3%). Most of the subjects (62.3%) believe that UI can cause infection, some (20.5%) believe that it can cause skin allergy and very few think that it can cause cancer or other disorders. Conclusions: Our findings indicate that although UI is relatively common in the community, it is underreported by Qatari women because of social and cultural attitudes and—most importantly—lack of information. This findings suggest that strategies to promote care-seeking for incontinence must be developed and employed in the community.

The prevalence and determinants of health care-seeking behavior for fecal incontinence in multiparous United Arab Emirates females.

This study was designed to determine the prevalence and sociodemographics of fecal incontinence in United Arab Emirates females. A representative sample of multiparous United Arab Emirates females aged 20 years or older (N = 450) were randomly selected from the community (n = 225) and health care centers (n = 225). Patients were interviewed about inappropriate stool loss in the past year using a structured and pretested questionnaire. Fifty-one participants (11.3 percent) admitted fecal incontinence; 26 (5.8 percent) were incontinent to liquid stool and 25 (5.5 percent) to solid stool. Thirty-eight patients (8.4 percent) had double (urinary and fecal) incontinence. Sixty-five patients (14.4 percent) were incontinent to flatus only but not to stools. The association between having fecal incontinence and chronic constipation was significant (P < 0.0001), but there was no significant association with other known risk factors such as age, parity, and previous instrumental delivery, episiotomy, perineal tears, or anorectal operations. Only 21 incontinent patients (41 percent) had sought medical advice. Patients did not seek medical advice because they were embarrassed to consult their physician (64.7 percent), they preferred to discuss the difficulty with friends, assuming that fecal incontinence would resolve spontaneously (47.1 percent) or was normal (31.3 percent), and they chose self-treatment as a result of low expectations for medical care (23.5 percent). Sufferers were bothered by the inability to pray (92.2 percent) and to have sexual intercourse (43.1 percent). Perceived causes of fecal incontinence were paralysis (90.2 percent), old age (80.4 percent), childbirth (23.5 percent), or menopause (19.6 percent). Fecal incontinence is common yet underreported by multiparous United Arab Emirates females because of cultural attitudes and inadequate public knowledge.

The prevalence and determinants of health care-seeking behavior for urinary incontinence in United Arab Emirates women.

The aim of this study was to determine the prevalence and sociodemographics of urinary incontinence (UI) in women in the United Arab Emirates (UAE). Women at risk, such as multiparous and climacteric women, were selected from the community (n = 200) and health-care centers (n = 200) and interviewed about inappropriate urine loss in the past 12 months, using a structured and pretested questionnaire. Of these, 81 (20.3%) admitted UI; only 25 of these (30.9%) had sought medical advice. The reasons were embarrassment (38.2%), choice of self-treatment because of low expectations from medical care (38.2%), and preferring to discuss the matter with friends, assuming that UI is normal (23.3%). Sufferers were troubled by their inability to pray (90%) and to have sexual intercourse (33.3%). Perceived causes of UI were paralysis (45%), childbirth (35.4%) and old age or menopause (33.7%). UI is common yet underreported by UAE women because of cultural attitudes and inadequate public knowledge.