Health Care Seeking Behavior Research Articles

Exploring the Health Care Seeking Behavior of Rohingya Community during COVID-19 Pandemic

Introduction: COVID-19 was declared a 'pandemic,' and it was the most horrific diseases the world. Objective: The study aimed to explore the healthcare-seeking behavior of Rohingya people during the COVID-19. Materials and methods: It was conducted as a cross-sectional study involving a sample size of 200 participants. Respondents were chosen through convenience sampling methods. The study population was the Rohingya population residing in Cox’s Bazar. A well-designed and pretested set of structured questionnaires was used to collect the information. The total study duration was for 3 months. Informed consent was taken from the participants, and Ethical clearance was taken from the IRB of AIUB. Data were analyzed using IBM STATA 16. Place and period of study: The study was conducted at Cox’s Bazar Rohingya Camp in Bangladesh. Results Majority (40%) of the respondents was aged between 30 to 49 years and 51% of them were female. A significant majority, 88%, expressed a preference for treatment at a Refugee health camp, while 9% opted for a Pharmacy and 3% chose a Traditional healer. Overall, 88% of respondents demonstrated positive behavior, in contrast to 12% who exhibited negative behavior. The results of a multivariate logistic regression analysis indicated that factors such as low educational attainment, fear of visiting health facilities, and a lack of awareness regarding COVID-19 prevention were significantly associated with negative health-seeking behavior. Conclusion: The healthcare-seeking behavior exhibited by the Rohingya community in Bangladesh during the COVID-19 pandemic has been observed to be commendable.

Quality of Life and Healthcare Seeking Behavior among Internal Migrant Laborers in Coimbatore, India: A Community-based Analytical Cross-sectional Study

Quality of Life and Healthcare Seeking Behavior among Internal Migrant Laborers in Coimbatore, India: A Community-based Analytical Cross-sectional Study

Downstream healthcare use following breast cancer screening: a register-based cohort study

BackgroundFor evaluation of breast cancer screening and informed prioritisation, it is important to examine the downstream healthcare use associated to participation. The objective of this study is to determine the...

The impact of conditional cash transfer (CCT) on health and education in a coastal community: A randomized control trial (RCT) and regression discontinuity design (RDD)

This study evaluates the impact of the Pantawid Pamilyang Pilipino Program (4Ps), a national conditional cash transfer (CCT) on the health and education of beneficiaries in the coastal community of Maangas, Presentacion, Camarines Sur. It compares households receiving 4Ps benefits to a control group of non-recipients with similar sociodemographic characteristics to establish counterfactuals. Using a Randomized Control Trial (RCT) approach, data were collected from 157 participants in each treatment and control group through structured questionnaires. Descriptive statistics were utilized to analyze the economic profiles of respondents, revealing diverse representations. Logistic regression models unveiled significant correlations between attendance, dropout rates, and various predictor variables, notably the 4Ps program and eligibility, location, household size, and perceptions. Regarding health outcomes, the analysis demonstrates the positive impact of 4Ps membership on reducing child mortality, improving child growth, and promoting healthcare-seeking behaviors. Factors such as clinic visits, health insurance, and health beliefs also significantly influence health outcomes. RDD underscores the effectiveness of the 4Ps program in poverty alleviation, with eligibility playing a key role in enhancing income outcomes among beneficiaries. Prioritizing access to healthcare services, reinforcing the importance of regular clinic visits, and optimizing child health outcomes are crucial steps towards sustainability of the program. Tailored interventions based on enrollment status and academic performance can help prevent student attrition. Providing aid to coastal communities and embedding livelihood support programs in 4Ps can break the cycle of poverty by integrating these initiatives into the current structure of the program.

Healthcare Seeking Behaviour and Associated Factor Among Community Based Health Insurance Members and Non-Members in Addis Ababa, Ethiopia, 2023

Background: Community based health insurance (CBHI) is voluntary, non-profit health insurance. It helps to mobilize additional resource to the health sector. Community Based Health Insurance uses principles of insurance, members pay fees to the insurance scheme and in return their health service cost is covered by the scheme. This way risks can be shared among individuals and financial inputs pooled between individuals who need health service but are not able because they cannot afford it and those who are well but pay premium. Objective: To assess health Care seeking behavior and Community based health insurance among members and non-members in Addis Ababa, Ethiopia 2023. Methodology: A community based comparative cross-sectional study was conducted. A total of 580 households included in this study. Data was collected by data collectors using a standardized questionnaire through interviews. Associated factors for healthcare seeking behavior is identified by binary and multivariate logistic regression analysis and expressed by adjusted odds ratio (AOR). Multivariate analysis also used to control the effect of confounders. Result: Healthcare-Seeking Behavior of the Study Participants Factors Associated with Healthcare-Seeking Behavior participants the study indicated that the decision-making to visit a health facility for illnesses, disease severity, and CBHI membership had a statistically significant association with HSB. Conclusion: The overall household Health Seeking Behavior was 56.3% for Community Based Health Insurance members and 43.7% for non-Community Based Health Insurance members. Membership status has significant positive effect on healthcare seeking behavior. Decision- making process to visit a health facility for illnesses, disease severity was positively associated with membership status.

How have respiratory tract infections changed in the post-covid era for children under 5 years?

Abstract Background Social distancing measures introduced in response to the covid-19 pandemic reduced transmission of all respiratory pathogens. Exposure to respiratory pathogens in early life affects future lung health. We aimed to describe changes in the incidence of respiratory tract infections (RTIs) in children <5 years in England in the post-pandemic era. Methods Population-based retrospective cohort study using electronic health records. We included all children aged <5 years registered with a primary care practice from April 2016 to March 2023. We compared monthly GP consultation rates for RTIs in the two post-pandemic years (April 2021 - March 2022 and April 2022 - March 2023) with corresponding months during pre-pandemic years (April 2016 - February 2020). Results There were 3 045 701 respiratory tract infections among 2 894 539 children <5 years registered with a GP practice during the study period. Pre-pandemic, monthly RTI rates varied from lows of 29.1 per 100 child-years in August to highs of 108.8 per 100 child-years in November. In 2021/22, monthly RTI rates were bimodal peaking in June and October, although the winter peak was lower than pre-pandemic years and mean monthly RTI rates were ∼15% lower overall. In 2022/23 mean monthly RTI rates remained ∼15% lower than pre-pandemic years, but there was a single peak in December 2022 of 117.6 RTIs per 100 child-years, exceeding the pre-pandemic winter peaks by 8.1%. Conclusions Overall, monthly RTIs in post-pandemic years were 15% lower than pre-pandemic years. However, there was a concerning peak in December 2022 that exceeded the winter peaks from previous years. Comparisons with national surveillance data suggest this peak reflects changes in RTI incidence, particularly among group A streptococcal infections, but this peak may also reflect changes in access to care or healthcare seeking behaviour. Continued monitoring of post-pandemic seasonal patterns will assist in planning for health service use. Key messages • Respiratory tract infections in children <5 years in post-pandemic years were 15% lower than pre-pandemic years, but winter peaks in incidence may be of greater magnitude in the post pandemic era. • Ongoing monitoring of patterns of respiratory tract infections in young children is important for future health service planning and delivery.

Assessing tuberculosis knowledge, attitudes, practices, and health-seeking behaviours of students at a selected university in South Africa

Tuberculosis (TB) remains a public health concern in South Africa, particularly among young adults. This study aimed to assess and investigate the attitudes, practices, and health-seeking behaviours of students at the University of KwaZulu-Natal (UKZN) regarding TB. The research provides valuable insights into the awareness of TB among students, their preventive practices, and their healthcare-seeking behaviours related to the disease. A cross-sectional design was employed, utilising a structured questionnaire to collect data from a representative sample of UKZN students on the Howard College campus. Data analysis involved descriptive statistics, such as frequencies and percentages, to summarise responses. Inferential statistics, including chi-square tests, were used to explore associations between variables and assess the knowledge, attitudes, and health-seeking behaviours of respondents. The study, which included 221 postgraduate and undergraduate students, revealed that participants were well aware of the symptoms, causes, and modes of TB transmission. The descriptive analysis indicated that 97.7% of respondents exhibited good knowledge about TB, with a total mean score of 0.977 and a standard deviation of 0.149. However, regarding health-seeking behaviours and practices, 53.4% of respondents demonstrated poor health-seeking behaviours, in contrast to 46.6% who exhibited good practices, with a mean score of 0.466 and a standard deviation of 0.499. Although all respondents indicated they would visit health facilities if they suspected they had TB, there was evidence of low screening practices and suboptimal health-seeking behaviours. Based on these findings, the study suggests leveraging social media to disseminate knowledge about TB to promote its prevention and treatment.

Changes in healthcare seeking behaviors among caretakers of children in the previously occupied ISIS territory: Hadeetha, Anbar, Iraq: a cross-sectional survey of 415 households.

The western province of Anbar, and the district of Hadeetha, have suffered direct impacts from the second United States led invasion (2003) through the ISIS invasion (2014-2017). With the primary health care centers being closed or inaccessible, the remaining population experienced changes in health seeking. The area of Anbar, Iraq remains largely remote from the discourse of health system recovery post-conflict. The objective of this study was to describe changes in health seeking behaviors of caregivers of children ages 12-72months of age in Hadeetha, Anbar, Iraq from the conflict period of ISIS (Islamic State of Syria and Iraq), 2014-2017, to the post-conflict period, 2021. This was a mixed-methods study composed of a cross-sectional 415 household survey and focus groups in Hadeetha, Anbar, Iraq. Caretakers of children were interviewed from February to April 2021. Children were sampled from a list of children who missed at least one vaccination appointment without a return for follow-up from the birth cohorts of 2014 to 2020. Healthcare workers focus groups and key informant interviews occurred from 2019 to 2021 centered around experiences from the 2014 to 2021 period. In the post-conflict period, there were no differences in health seeking based upon provider type between respondents. Physicians were primary healthcare providers in the post-conflict period for 79% of respondents versus only 47% in the conflict period. Healthcare workers described major barriers to delivering services in Hadeetha during the ISIS occupation due to infrastructure damage, threats of violence, decreased medical personnel, lack of compensation and disruptions in medical supplies from 2014 to 2017. This study provides insight into health seeking challenges among the many individuals who remained in Hadeetha during the ISIS occupation. Health use patterns by provider type mirror the concerns the healthcare providers shared: limited availability, efflux of professional workers, limited resources and security challenges to providing care. Positive trends toward increased access to physicians during periods of peace are an encouraging marker for continued population resilience during the post-conflict period. Recovery efforts continue to be hampered by internal sectarian discord within Iraq as well as insufficient resources to maintain health services as well as provide catch-up health services, such as immunizations.

Health Disparities and the Influence of Culturally Competent Care in Overall Health and Healthcare Utilization among Hispanics in a Southeastern US Community.

Introduction: This study sought to assess disparities in health/healthcare utilization for Hispanic immigrant community in Greenville County, SC. The study also assessed the role of culturally competent care perceptions on health/healthcare utilization within this growing community. Methods: Secondary administrative data collected by a large health care system in the county facilitated the assessment of health/healthcare utilization disparities using multivariate regression. Primary purposive surveys collected among Hispanic adults assessed culturally competent care perceptions and health/healthcare utilization. Culturally competent care measures included: (1) provider understanding, (2) provider communication behaviors, (3) provider assurance, and (4) interpreter service access. Results: Health disparities were present, with Hispanic residents having lower overall health and lower routine healthcare seeking behaviors compared to non-Hispanic White residents. Moreover, culturally competent care perceptions influenced overall health and healthcare-seeking behavior within this growing Hispanic community. Hispanic residents who perceived negative communication behaviors, lack of assurance, and increased interpretive service barriers reported lower overall health and lower routine healthcare seeking behaviors. Conclusions: Addressing potential cultural competency barriers may reduce health disparities among underrepresented racial/ethnic communities as they grow and become established in the Southeast, while also improving broader health equity for all communities.

Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

Healthcare leadership practice and associated factors among primary healthcare managers in East Gojam Zone, Northwest Ethiopia: a mixed method study

BackgroundLeadership plays a critical role in the delivery of person centered, safe, efficient, and effective healthcare services globally. Poor healthcare leadership contributes to low staff motivation, patient dissatisfaction, and reduced healthcare-seeking behavior. However, there is limited evidence on healthcare leadership practice and associated factors among primary healthcare managers in the study area and at large in Ethiopia. Therefore, the findings of this study will contribute to improved healthcare leadership practices among primary healthcare managers.MethodFacility-based cross-sectional study supplemented with qualitative inquiry was conducted in the East Gojam zone among 532 primary healthcare managers selected by a two-stage stratified random sampling technique. A pre-tested and structured self-administered questionnaire was used to collect the quantitative data. Data were entered into Epi-Data version 4.6 and exported into Stata version 14.0 for analysis. Multiple linear regression analysis was used to identify factors associated with healthcare leadership practice, and statistical significance was declared at a p-value < 0.05 with a 95% CI. Six key informant interviews were conducted, and thematic analysis was used for the qualitative study.ResultThe magnitude of healthcare leadership practice among primary healthcare managers in the East Gojam zone was 45.7% (95% CI: (41.4, 50.0)). Factors associated with healthcare leadership practice were age [β = 0.44, 95% CI: (0.16, 0.71)], training in healthcare leadership practice [β = 1.19, 95% CI: (0.19, 2.20)], experience sharing [β = 1.68, 95% CI: (0.59, 2.76)], organizational communication [β = 0.19, 95% CI: (0.05, 0.33)], managerial working experience [β = 0.94, 95% CI: (0.18, 1.69)] and emotional intelligence [β = 0.35, 95% CI: (0.31, 0.38)].Conclusion and recommendationThe magnitude of healthcare leadership practice among primary healthcare managers in the East Gojam zone was low as compared with a previous study in Ethiopia. It was significantly associated with age, training in leadership, experience sharing, organizational communication, managerial working experience, and emotional intelligence. Thus, human resource managers at primary healthcare level should consider older and more experienced candidates during assigning managers, organize training on healthcare leadership and experience sharing with model managers to improve the leadership practice of primary healthcare managers in the East Gojam zone.

Health care seeking behaviour of patients reporting to a dental health Institution- A cross sectional study

This study aimed to assess the factors influencing healthcare-seeking behaviour among patients presenting to a dental institution. Oral diseases, such as dental caries and periodontal diseases are prevalent global health concerns, particularly in developed countries, whereas oral cancers are more common in developing countries. In India, there is observed lower utilization of dental care services and higher rates of dental problems. This descriptive study involved 220 patients who visited a dental college and hospital in India. Patients were interviewed to gather information on their chief complaint, history of previous treatment for the complaint, and reasons for delaying dental treatment. The study identified several key factors contributing to delays in seeking dental treatment. Negligence was cited by 27.1% of patients, absence of symptoms by 14.5%, and financial constraints by 9%. Gender, occupation, and education level of patients also showed varying impacts on healthcare-seeking behaviour. Negligence, lack of symptom awareness, and financial constraints, particularly in rural and suburban areas were the significant barriers to timely dental treatment among patients in a dental institution in India.

Examining health literacy in the Danish general population: a cross-sectional study on the associations between individual factors and healthcare-seeking behaviour.

Knowledge about health literacy challenges among the general population is valuable for initiatives targeting social inequity in health. We investigated health literacy in various population groups and the impact of healthcare-seeking behaviour by analysing the associations between (i) lifestyle, socioeconomics, self-rated health, chronic disease, and health literacy and (ii) symptom burden, contact to general practitioner (GP), and health literacy. In total, 27488 individuals participated in a population-based survey. Questionnaire data comprised information about symptoms, GP contact, lifestyle, self-rated health, chronic disease, and four aspects of health literacy: feeling understood and supported by healthcare providers, having sufficient information about health, having social support for health, and being able to actively engage with healthcare providers. Socioeconomics were obtained from registers. Descriptive statistics and multivariable linear regression models were applied. Individuals who smoked, lived alone, had different ethnicity than Danish, and low self-rated health had more health literacy challenges reflected in lower scores for all aspects of health literacy. Individuals with high symptom burden and those who had presented a high absolute number of symptoms to their GP were less likely to have sufficient information about health and be able to actively engage, whereas individuals reporting GP contact with a high relative percentage of their symptoms were more likely to feel understood and supported by healthcare providers. Health literacy challenges are related to healthcare-seeking behaviour and several individual factors. To address social inequity in health and society, interventions aimed at both the individual and community-based health literacy are essential.

IMPACT OF SEX AND GENDER IN STROKE IN SOUTH-AND-SOUTHEAST ASIA: A RAPID SCOPING REVIEW.

South Asia and Southeast Asia account for more than 40% of the global stroke burden, with differences in stroke risk factors, mortality, and outcomes compared to high-income countries. Socio-cultural norms compound the pre-existing biological risk differences, resulting in a disproportionate burden of stroke in women in this region. This review summarizes the sex and gender differences across the stroke care continuum in South Asia and Southeast Asia over the past 20 years. Despite a higher incidence of stroke in men than women in South-and-Southeast Asia, women have greater stroke severity and poorer outcomes after stroke. Higher levels of pre-morbid disability and poor physical health at baseline may be contributory. There is a high prevalence of vascular risk factors such as hypertension, dyslipidemia, cardiac sources of embolism, as well as metabolic syndrome and insulin resistance, among the women in this region. Smoking is uncommon among women, however other forms of smokeless tobacco (SLT), such as tobacco leaf and betel nut chewing are more prevalent, especially in the rural areas in these countries. Women are more likely to have delayed presentations to the hospital due to untimely recognition of stroke symptoms, however, with regards to door-to-needle times or intravenous thrombolysis (IVT) rates, we found equivocal data. Wide gaps exist in stroke awareness and healthcare-seeking behaviors, with women more commonly opting for public hospitals and low-cost wards, more likely to discontinue treatment, and less likely to adhere to post-stroke rehabilitation. This review exposes the gender lacunae in stroke service provision across South Asia and Southeast Asia while acknowledging the many knowledge gaps in our understanding. Although the biological risk differences are non-modifiable, educational, policy, and economic measures to mitigate socio-cultural barriers are much needed in the region. Sound epidemiological data is needed from more countries to better understand these differences and bridge this gap. It is imperative to advocate and implement policies and programs for stroke care viable for women, cognizant of the gender and cost bias, as well as the interplay of social and cultural structures specific to the regions.

Healthcare-seeking behavior for diarrhea in under-five children and associated factors in sub-Saharan Africa: a multilevel robust Poisson regression model.

Diarrhea is one of the leading causes of child death in sub-Saharan Africa (SSA). Children with diarrhea who do not receive medical advice or treatment are at high risk of poor health outcomes and increased mortality. Prompt and adequate treatment is essential to mitigate these risks. However, studies that have been conducted on the factors influencing healthcare-seeking behavior (HSB) for diarrhea in under-five children in SSA are scarce. Therefore, the purpose of this research was to determine the variables related to HSB for diarrhea in children under the age of five. A secondary data analysis was conducted on the most recent data from the Demographic and Health Surveys in 35 SSA countries. The study included a total weighted sample of 51,791 children under the age of five with diarrhea. We presented the adjusted prevalence ratio and the 95% confidence interval in the multivariable multilevel robust Poisson regression analysis to show the statistical significance and strength of the association between HSB and its determinants. The pooled prevalence of HSB for diarrhea in under-five children was 58.71% (95%CI: 55.39 to 62.04). Factors found to be associated with HSB included maternal age, education and working status, antenatal care visits, postnatal checkups for the child, wasting, distance to a health facility, SSA region, and country income level. More than 40% of under-five children with diarrhea in SSA did not receive medical advice or treatment. To improve healthcare-seeking behavior, effective health policy interventions are necessary. These include enhancing the education and employment status of mothers, promoting regular antenatal and postnatal care visits, building health facilities in close proximity, and raising awareness in the community about the importance of seeking healthcare services for malnourished children.

Narratives of resilience: Understanding Iranian breast cancer survivors through health belief model and stress-coping theory for enhanced interventions

Breast cancer poses a significant global health challenge, with Iran experiencing particularly high incidence and mortality rates. Understanding the adaptation process of Iranian breast cancer survivors’ post-treatment is crucial. This study explores the health perceptions, barriers, and coping mechanisms of Iranian survivors by integrating Stress-Coping Theory (SCT) and the Health Belief Model (HBM). Semi-structured interviews were conducted with 17 survivors, and a grounded theory approach guided the deductive content analysis of the data. The findings reveal key themes, including perceived susceptibility, benefits, barriers to care, cues to action, self-efficacy, and appraisal of action. Perceived susceptibility highlights diagnostic challenges stemming from practitioner errors and symptom misconceptions. Perceived benefits underscore the importance of early detection and support from healthcare providers and families. Barriers include cultural and financial obstacles, while cues to action reflect the influence of media, family, and personal experiences on healthcare-seeking behavior. The study also examines coping strategies, such as problem-focused and emotion-focused approaches, along with family support and external stressors. To address these barriers and enhance support systems, the study suggests specific strategies for healthcare providers, including targeted training to improve diagnostic accuracy and patient communication. Culturally sensitive awareness campaigns can correct symptom misconceptions, while financial counseling can mitigate economic barriers. Establishing community-based support groups and involving family members in care plans can enhance emotional and psychological support. These strategies aim to overcome the identified barriers and improve support systems for Iranian breast cancer survivors, ultimately fostering better recovery outcomes.

Disparities in healthcare-seeking behaviors and associated costs between Venezuelan migrants and Colombians residing in Colombia

BackgroundColombia, which hosts over 3 million of the Venezuelan diaspora, is lauded for its progressive approach to social integration, including providing migrants access to its universal health coverage system. However, barriers to healthcare persist for both migrant and host populations, with poorly understood disparities in healthcare-seeking behaviors and associated costs. This is the first study to link healthcare-seeking behaviors with costs for Venezuelan migrants in Colombia, encompassing costs of missing work or usual activities due to healthcare events.MethodsWe use self-reported survey data from Venezuelan migrants and Colombians living in Colombia (September-November 2020) to compare healthcare-seeking behaviors and cost variables by nationality using two-sampled t-tests or Chi-square tests (X2). The International Classification of Diseases was used to compare reported household illnesses for both populations. Average health service direct costs were estimated using the Colombian Government’s Suficiencia database and self-reported out-of-pocket (OOP) payments for laboratory and pharmacy services. Indirect costs were calculated by multiplying self-reported days of missed work or usual activities with estimated income levels, derived by matching characteristics using the Gran Enquesta Integrada de Hogares database. We calculate economic burdens for both populations, combining self-reported healthcare-seeking behaviors and estimated healthcare service unit costs across six healthcare-seeking behavior categories.ResultsDespite similar disease profiles, Venezuelan migrants are 21.3% more likely to forego formal care than Colombians, with 746.3% more Venezuelans reporting lack of health insurance as their primary reason. Venezuelan women and uninsured report the greatest difficulties in accessing health services, with accessing medications becoming more difficult for Venezuelan women during the COVID-19 pandemic. Colombians cost the health system more per treated illness event (US$40) than Venezuelans (US$26) in our sample, over a thirty-day period. Venezuelans incur higher costs for emergency department visits (123.5% more) and laboratory/ pharmacy OOP payments (24.7% more).ConclusionsWhile Colombians and Venezuelans share similar disease burdens, significant differences exist in access, cost, and health-seeking behaviors. Increasing Venezuelan health insurance enrollment and tackling accessibility barriers are crucial for ensuring healthcare equity and effectively integrating the migrant population. Findings suggest that improving migrant access to primary healthcare would produce savings in Colombian healthcare expenditures.

Impact of NHI copayment adjustments on healthcare seeking behavior: the mediating role of health facility identification

ObjectiveThis study investigates the impact of healthcare consumers’ involvement, price perception, and attitude toward National Health Insurance (NHI) copayment adjustments on their healthcare-seeking behavior, focusing on the mediating role of health facility identification.MethodsA questionnaire survey was conducted among outpatient customers in Taiwan from October 2023 to March 2024, resulting in 746 valid responses. The survey included demographic variables, involvement, price perception, attitude, health facility identification, and healthcare-seeking behavior. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis with SPSS 20.0.ResultsThe study found that involvement, price perception, and attitude significantly influence healthcare-seeking behavior. Health facility identification was identified as a significant mediator in the relationship between copayment perception and healthcare-seeking behavior. The regression analysis also highlighted the impact of demographic factors such as age, education level, marital status, and annual income on healthcare-seeking behavior. The path model illustrated the complex interplay between perceptual factors and their influence on healthcare-seeking behavior.ConclusionThis study emphasizes the importance of consumer involvement, price perception, and attitude in shaping healthcare utilization patterns. Health facility identification plays a crucial mediating role, suggesting that stronger patient-provider relationships can mitigate potential negative impacts of copayment adjustments. Policymakers and healthcare providers should enhance patient engagement, foster strong patient-facility identification, and provide targeted support for vulnerable groups to ensure equitable access to healthcare services despite copayment changes.

Factors Affecting Health Seeking Behavior of Elderly People in a Community of Pokhara, Nepal

Introduction: Individuals have different opinion regarding willingness to seek help from health care services. Thus, a study aimed to find out the health care seeking behaviour, factors affecting health care seeking behaviour and association between health seeking and those factors among elderly people. Methods: Cross-sectional analytical study was conducted among 197 elderly people of 65 years and above in Pokhara Metropolitan City Ward No.28. Non probability purposive sampling technique was used. Data was collected by face to face interview technique using self-developed structured interview schedule. SPSS 16 was used for data analysis. Descriptive statistics frequency, percentage, mean and standard deviation were used for data analysis. Inferential statistics (Chi-square test) was used to reveal the association between the selected factors and health seeking behaviour.. Results: Finding showed 77.66% of respondents sought appropriate health care where as only 22.34 % of respondents sought inappropriate health care. Among those who sought care from appropriate health care, 65.48% of respondents sought care from governmental hospital. Among those who sought inappropriate health care still 22.72 % of respondents had belief in traditional healer. Accompany for the treatment of elderly was found statistically significant and other factors was not found statistically significant Conclusion: Based on the findings more than two third of the respondents reported that they seek appropriate health care. Among those respondents nearly half of respondents’ reason for seeking appropriate health care was good experience of medical treatment in the past. Among those whose health seeking behaviour is inappropriate, still one fourth of respondents had belief on traditional healer. Key words: Health seeking behavior; Elderly people; Nepal

Determinants of Timely Healthcare-Seeking Behaviour and Knowledge of Childhood Danger Signs in Caregivers of Children Below Five Years Attending Gita Sub-County Hospital, Kisumu, Kenya

Morbidity and mortality in children below five years are still relatively high even after many interventions, especially and low and middle-income countries. Many of the deaths are due to preventable causes. Timely seeking of healthcare from qualified personnel as soon as the child shows signs and symptoms of disease is a game changer, especially to the treatment outcomes. However, this is determined by various factors including the caregiver’s age and knowledge about childhood illnesses, including danger signs. This cross-sectional study aimed to investigate the determinants of timely healthcare-seeking behaviour and knowledge of danger signs in caregivers of children below five years attending Gita Sub-County Hospital in Kisumu, Kenya. Systematic sampling was used to include 324 caregivers in the study. Using structured pretested interview-guided questionnaires, data was collected, cleaned and analysed using into GraphPad Prism 10.2.0 (392). The mean age of the participants was 28.38 years. Knowledge about childhood danger signs in children by their caregivers was poor (35%). Age (31-40 and 41-50 years at [AOR=1.32(95%CI: 0.77-1.87) and AOR=1.29(95%CI: 0.76-1.82)] respectively), secondary [AOR=1.34(95%CI: 1.14-1.54)] and tertiary education [AOR=2.07(95%CI: 0.8-3.33)]), formal employment [AOR=1.62(95%CI: 1.31-1.92)] and no source of income [AOR=1.75(95%CI: 0.61-2.89)] improved caregivers’ knowledge about danger signs in children. Timely healthcare seeking for sick children was low (25%). Age (≤ 20 years [ AOR=3.89 (95%CI: 2.43-5.34)]), marital status (divorced/separated, single and widowed caregivers [AOR=2.55(95%CI: 0.91-4.18), AOR=2.46(95%CI: 1.67-3.24) and AOR=2.41(95%CI: 1.92-2.89) respectively]), source of income (formally employed and self-employed [(AOR=2.9(95%CI: 2.45-3.34) and AOR=2.42(95%CI: 1.89-2.92)] were promotors of timely healthcare seeking. Caregivers need to be sensitized about danger signs in their children and the need to seek timely healthcare once their children present with any one of the danger signs