Health-seeking Behaviour Of Individuals Research Articles

The social determinants of health and health seeking behaviour in populations affected by armed conflict: a qualitative systematic review

ABSTRACT This systematic review explored the relationship between the social determinants of health and health seeking behaviour of individuals affected by armed conflicts. A systematic search of all available evidence was conducted through well-known academic databases. Seven studies met the inclusion criteria and were quality assessed. The synthesis revealed that the social determinants of health in times of conflict also determine the level of health seeking in these individuals. The social determinants were grouped in three main themes a) individual and economic b) sociocultural c) political and health systems. The three themes show that armed conflicts affect health seeking behaviour of individuals in a multi-layered manner with strong connections across the social determinants. This review shows that individuals are forced to choose between fulfilling their basic needs and attending health services. This is further compounded by the lack of health provision in conflict settings. Future research must address the social determinants of health when examining health seeking behaviour of conflict affected populations.

Social determinants and individual health-seeking behaviour among women in Kenya: protocol for a breast cancer cohort feasibility study

IntroductionA catastrophic 35% increase in the burden of breast cancer in Kenya has been predicted by 2025. Mitigating this burden is critical, and local research is necessary to generate the...

Examining horizontal inequity and social determinants of inequality in facility delivery services in three South Asian countries.

BackgroundThe utilization of maternal health care services has increased in many developing countries, but persistent wealth-related inequalities in use of maternal services remained an important public health issue. The paper examined the horizontal inequities and identified the key social determinants that can potentially explain such wealth-related inequalities in use of facility delivery services.MethodsThe countries studied are Bangladesh, Pakistan and Nepal. We used horizontal inequity index to measure the horizontal inequity and decomposition of concentration index method to assess the contribution of different social determinants towards the wealth-related inequality. We have used household and women data from demographic and health surveys of Bangladesh (BDHS 2014), Pakistan (PDHS 2012-13) and Nepal (NDHS 2010-11).ResultsAll three countries showed pro-rich inequality in use of facility delivery services (Observed Concentration Index: Bangladesh = 0.235; Pakistan = 0.141; Nepal = 0.263). The study showed if the utilization were solely based on need factors there would have been little disparity between the rich and the poor (Need expected Concentration Index: Bangladesh = 0.004; Pakistan = 0.004; Nepal = 0.008). The use of facility delivery remained pro-rich in all three countries after taking the need factors into account (Horizontal inequity Index: Bangladesh = 0.231; Pakistan = 0.137; Nepal = 0.254). The decomposition analysis revealed that facility delivery is driven mostly by the social determinants of health rather than the individual health risk. Household socioeconomic condition, parental education, place of residence and parity emerged as the most important factors.ConclusionsOur study reiterates the importance of addressing social determinants of health in tackling wealth-related inequalities in use of facility delivery services. Health policy makers should acknowledge the importance of social determinants in determining individual health-seeking behaviour and accordingly set their strategies to improve access to facility delivery.

An epidemiological study of clinic attendees at the first specialised clinic for individuals with intellectual disability in Sri Lanka

Background Intellectual disability (ID) is diagnosed when both intellectual and adaptive functioning deficits are shown in conceptual, social and practical domains during the developmental period. A higher prevalence of ID in areas of lower socioeconomic status and developing countries is noted. No published studies of ID were found for Sri Lanka. Aims To describe the epidemiology and pattern of health seeking behaviour of individuals with ID attending a specialised clinic. Methods Data were extracted from the records of all individuals registered at the specialised clinic for mentally retarded individuals at Teaching Hospital, Peradeniya, from 1984 to 2013. Results One thousand three hundred and thirty five patient records were perused. The mean age at first presentation was 11.7 years. The majority (60.7%) were males. Mild, moderate and severe ID was diagnosed in 78.9%, 15.6% and 5.5% respectively. The main presenting problem was poor scholastic abilities (54.8%). Epilepsy was the main associated medical condition. Activities of daily living (ADLs) were impaired in 31.8% of subjects. A majority-received no behavioural interventions. Conclusion There was a 33-fold increase in help seeking behaviour, over the 29 year study period. The findings of this study highlight the epidemiology of ID in Sri Lanka, and the need for more clinics and a national policy for ID.

Evaluating Nationwide Health Interventions: Malawi’S Insecticide-Treated-Net Distribution Programme

Summary We evaluate Malawi's main malaria prevention campaign, a nationwide insecticide-treated-net distribution scheme, in terms of its effect on infant mortality. Methodologically, evaluating such nationwide health interventions is particularly difficult. There is no contemporaneous comparison group that has not been subject to the intervention. Moreover, common environmental trends, the availability of new drugs and a variety of other health improving measures used at the same time imply that the often advocated before–after estimator is not a good choice. We propose an alternative estimator that can be used if the intervention influences health through its effect on individual health-seeking behaviour but has no other effect on the outcome. We also suggest some plausibility checks and falsification tests to assess the validity of the identifying assumptions that we impose in applications. Using the estimator proposed we find that Malawi's insecticide-treated-net distribution campaign reduced all-cause child mortality by about 1 percentage point, which corresponds to about 40% of the total reduction in infant mortality from 8.2% to 5.4% over the study period.

Gender biases and discrimination: a review of health care interpersonal interactions

A good interpersonal relationship between a patient and provider, as characterized by mutual respect, openness, and a balance in their respective roles in decision-making, is an important marker of quality of care. This review is undertaken from a gender and health equity perspective and illustrates that gender biases and discrimination occur at many levels in the healthcare delivery environment, and affects the patient–provider interaction which can result in health inequities affecting individual health seeking behaviour, access to good quality healthcare, and, ultimately, health outcomes. Interventions will have to be introduced at multiple levels, from health system legislation and policy and gender sensitive training to the development of women and men centred services and health literacy programmes.

Communication Strategy for Implementing Community IMCI

ABSTRACT In resource-poor developing countries, significant improvements in child survival, growth, and development can be made by: (a) shifting from sectoral programmes (for example, in nutrition or immunization) to holistic strategies such as the Integrated Management of Childhood Illnesses (IMCI) and (b) improving household and community care and health-seeking practices as a priority, while concurrently strengthening health systems and the skills of health professionals. This article focuses on household and community learning, and proposes a communication strategy for implementing community IMCI (c-IMCI) that is based on human rights principles such as inclusion, participation, and self-determination. Rather than attempt to change the care practices and health-seeking behaviour of individuals through the design and delivery of messages alone, it proposes an approach that is based on community engagement and discussion to create the social conditions in which individual change is possible. The strategy advocates for the integration of sectoral programmes rather than the development of new holistic programmes, so that integrated programmes are created from “multiple entry points.” As integration occurs, the participatory communication processes that are used in sectoral programmes can be enriched and combined, improving the capacity of governments and agencies to engage community members effectively in a process of learning and action related to child health and development.

Health-seeking behaviour of individuals with a cough of more than 3 weeks

Sex inequalities can lead to poorer access to health care and delays to diagnosis of tuberculosis in women. In a population-based survey we assessed health-seeking behaviour in adults with long-term cough. The prevalence of cough was 1% (213) and 2% (279) in men and women, respectively. Women took more health-care actions than men, but chose less qualified providers and reported lower health expenditure per visit. Delay before seeking hospital treatment was longer for women (41 days) than men (19 days; p=0.04), and more men (27; 36%) than women (14; 14%; p=0.0006) reported giving a sputum sample at hospital. Sex-sensitive strategies for tuberculosis control are needed and should take into account sex differences in health-care seeking behaviour as well as a possible sex bias among health-care providers.

Radiological study of the sacroiliac joints in vertebral ankylosing hyperostosis.

A radiological study of the sacroiliac joints was undertaken in 54 patients (32 males, 22 females) with vertebral ankylosing hyperostosis (VAH) and in 46 control patients (24 males, 22 females) matched for age and sex. The ages ranged from 38 to 90 years. The radiographs were taken in anteroposterior, oblique, and craniocaudal projections. The films were read for cranial, ventral, and caudal capsular ossifications, for ventral and caudal osteophytes, and for bone sclerosis. Cranial and/or ventral capsular ossifications were found in 28 (87.5%) males with VAH and in 4 (16.6%) control males (p less than 0.0005), but only in 2 females with VAH and no control female. Sacroiliac capsular ossifications in males with VaH are frequent from the onset, but complete bridging of the joint is not reached before the sixth decade. Women, either VAH or control, have more sacroiliac osteophytes than men. There were 11 out of 22 control women with osteophytes versus 4 out of 24 men (p less than 0.025). The incidence of osteophytes does not seem to increase with age after 50 years. Our findings support the idea of VAH being a distinct entity and not a major form of osteophytosis.