Health-seeking Behaviour Of People Research Articles

Distress financing associated with out-of-pocket expenditure for non-communicable diseases in India

ABSTRACT Objective The objective of this study is to assess the coping mechanisms used by the households who incur out-of-pocket expenditure (OOPE) due to Non-communicable Diseases (NCDs). Also, it seeks to examine the underlying factors responsible for various coping strategy. Data and Methods Data from the 75th round of the National Sample Survey Office (NSSO) has been used for the study. Descriptive statistics, concentration index (CI), and multinomial logistic regression have been employed to do the analysis. Results Households having cancer patients have a higher rate (46.80%) of distress financing, followed by cardiovascular diseases (27.43%), chronic respiratory diseases (26.91%), and diabetes (24.77%). The result of multinomial logistic regression shows that households belonging to the other caste categories, availing healthcare at private health centre, lower economic status, lack of insurance coverage, and households with casual labour are more likely to depend upon distress financing for NCDs hospitalisation. Conclusion The issue of financing inpatient care for NCDs, specifically cancer and cardiovascular diseases, is a significant concern in India. Therefore, an increase in public expenditure and investment in public health facilities is essential to increase health seeking behaviour of people by reducing OOPE, particularly among the poor and marginalised groups.

The Doctrine of Retribution and Religious Responses to the HIV and AIDS Pandemic

Despite many decades of interfacing with the HIV and AIDS pandemic, religious responses to the plight of the affected and infected still border on the doctrine of retribution. Some religious leaders, particularly from the Christian perspective, are still preaching about the intersection between infection and promiscuity in relation to the HIV and AIDS pandemic. Such a message from the pulpit overlooks people born with HIV infection and partners, more particularly women in long term permanent relationships including marriage, who are unknowingly infected with HIV. Additionally, religious doctrines and religious moral positions embody perceptions that regard the infected as deserving due punishment for their sins. Using desktop research and drawing from the Job narrative, our article seeks to explore the influence of religion on HIV and AIDS. It acknowledges the ambivalent interface between sexuality, gender and HIV and AIDS, taking into account how such interwoven issues affect health seeking behavior of people living with HIV and AIDS (PLWHA). Espousing the Job narrative as wisdom in revolt, the article acknowledges the complexity of HIV infection and negates the doctrine of retribution. It concludes by proffering an alternative, holistic and sensitive theological response in the face of the HIV and AIDS pandemic.

INTER-STATE DISPARITIES IN HEALTHCARE COSTS, HEALTH INSURANCE COVERAGE AND FINANCIAL PROTECTION IN INDIA: A COMPARATIVE ANALYSIS OF NATIONAL SAMPLE SURVEYS FOR 1986-87, 1995-96, 2004 AND 2014

By analysing data from the National Sample Survey for four rounds (1986–87, 1995–96, 2004 and 2014) this research focuses on changes in people's health seeking behaviour, the cost of treatment, and principal factors affecting health insurance premium payments by BPL and APL families. With variations between states, it is discovered that over time, less people sought care from public providers and more people preferred private providers. Despite the fact that both men and women are now more likely to seek treatment for their illnesses, a sizeable portion of the population (more in rural than in urban areas), still refuses treatment because they believe their illness is not serious enough to warrant it. Whilst the cost of healthcare has gone up over time, the difference between public and private costs of treatment has shrunk, possibly as a result of the higher recurring cost in public health facilities and imposing of user fees and cutting on the delivery of free medication. Since the middle of the 2000s, public insurance companies have offered low-cost hospitalisation insurance programmes like the Jan Arogya Bima Policy and Rashtriya Swasthya Bima Yojana (RSYB) to help with the healthcare needs of the underprivileged sector of society. According to the insurance premiums, more households that paid premiums in 2004 and 2014 belonged to groups with higher Monthly Per Capita Expenditures (MPCE) and were not economically in the poorest tier. The inter-quintile MPCE differential (between the top and bottom quintile) also reveals significant inter-state disparities in terms of the percentage of households that paid a premium and the percentage of households that had health insurance. The factors that determine whether a family enrols in health insurance imply that increasing enrolment from the poor households got coverage through RSBY. At the national level, BPL/APL households with insurance reported, on average, higher hospitalisation costs than non-insured households, with the difference being significantly higher for urban households. This finding suggests the prevalence of insurance collusion and moral hazard, particularly in the cities from developed states of Punjab, Haryana, Gujarat, and Maharashtra. Further, BPL households, particularly from rural India, have received very little financial relief as a result of the insurance.

An Assessment of Major Factors Contributing towards Choosing Alternate Healers (Hakeem, Dispenser, Spiritual Healer) over Registered Medical Practitioner (RMP)

Background: Malpractice is characterized as "careless, unsuitable, or illegal activity while performing a professional task" by Oxford Learner's Dictionaries (1). Prevalence of alternate healers is a problem of nearly all less economically underdeveloped countries. Pakistan is also one of the victims of malpractice. Factors that contribute to malpractice are proximity, affordable fee, availability, family pressure, and the strong opinion of the community. The objective of the study was to analyze why people choose alternate healers and to evaluate the misconception and myths regarding registered medical practitioners. Methods: A Descriptive cross-sectional study was conducted on a sample size of 319 with participants from Gujranwala’s rural and urban areas in 2021. Both the male and female population of Gujranwala was included. Data was entered and analyzed in SPSS version 21. Results: The socio-economic and demographic variables considerably effect the choice of health care provider. More people in rural areas visit alternate healers as compared to urban areas. Lack of information and misconceptions about physicians were also the factors effecting health seeking behavior of people. Conclusion: There is a potential to improve the health-seeking behavior and utilization of health facilities by addressing the demand side (community) factors i.e., socio-economic factors, cultural beliefs, by shutting down all unlicensed practitioners and educating the community to avoid visiting them to reduce the probability of exposure to unsafe healthcare practices.

Googling Alzheimer Disease: An Infodemiological and Ecological Study

Introduction: Understanding the emergent role of the internet on the health-seeking behavior of people is critical not only in the areas of medicine and public health but also in the field of infodemiology. Methods: Using Google Trends, data on global search queries for Alzheimer disease (AD) between January 2004 and April 2021 were analyzed. The relationship between online interest, as reflected by search volume index (SVI), and measures of disease burden, namely prevalence, deaths, and disability-adjusted life years, was evaluated. Results: There was a reduction in the tendency to search for AD during the past two decades. SVI peaks corresponded to news of famous people with AD and awareness months. Symptoms, causes, and differences with the term dementia were central queries for persons interested in AD. No notable overall correlation between SVI and measures of disease burden was found due to competing results. Sub-group analyses, however, showed that these correlations may be influenced by socioeconomic development, with strong negative significant associations observed in lower middle-income countries. Conclusion: Online interest in AD may represent a more complex metric influenced by socioeconomic factors. Awareness of the impact of celebrity diagnosis and awareness months on online search behavior may prove useful in the planning of public health campaigns for AD.

Health-Seeking Behavior of People in Five Sub-Districts in Karawang Regency

Background: Health-seeking behavior is an individual’s action to maintain and improve their degree of health and/or search for treatment, and it is influenced by many factors. The objectives of this study were to identify the preferences and reasons of people to visit healthcare facilities.Methods: This study was a descriptive study, conducted on November 5th 2019 at five sub-districts in Karawang Regency. Data were collected from all respondents using a guided questionnaire by trained enumerators. The respondents who did not complete the questionnaire were excluded from this study. Data were analyzed using Microsoft Office Excel 2013 and presented in percentages.Results: Out of 430 subjects, 18.6% were male and 81.4% were female, who were mostly in the age range of ≥ 18 years (99.5%). The sub-district health community center (Puskesmas) was the healthcare facilities most frequently visited and most preferred (39.7% and 40.9%), followed by a private clinic (21.3% and 22.3%) and a midwife (18.1% and 17.9%). Additionally, accessibility, affordability of the treatment cost, and waiting time were the main factors that influence people’s decision in using the healthcare facilities.Conclusion: The sub-district health community center was the healthcare facilities most frequently visited and most preferred by respondents. Accessibility, cost affordability, and waiting time were the factors that influence people’s decision in using the healthcare facilities.

Cognitive Dissonance in Health-Seeking Behavior of People in Indonesia to Prevent Covid-19

During the Covid-19 pandemic, many people experience cognitive dissonance, including in the process of seeking health. In the Covid-19 pandemic, people have to deal with various kinds of information, thoughts, and beliefs about Covid-19. Having a relevant but inconsistent cognition can create psychological discomfort or dissonance. The feeling of discomfort has made people try to seek health. Indonesian people’s health-seeking behavior is unique because of certain beliefs, information, perceptions, cultures, and unique environments in Indonesia. So, this study aims to analyze the cognitive dissonance process that occurs in Indonesian people's health-seeking behavior in the Covid-19 pandemic. This study is a literature study. We use secondary data of literary works, scientific journals, books, articles in the mass media, and statistical data as study objects. The results of this study indicate that the cognitive dissonance theory can be applied to answer the health-seeking behavior of Indonesian people in the Covid-19 pandemic. Many people in Indonesia choose traditional medicine to prevent Covid-19 because it is believed to be a natural treatment, has empirical evidence, and is easy to do independently. Many people in Indonesia choose traditional medicine because it is influenced by hereditary beliefs, culture, and also the variety of information they hold.

A study of factors affecting the health seeking behaviour of people with pre-existing mental illness during the COVID-10 pandemic

Health or care seeking behavior has been defined as any action undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate remedy. A little understanding exists concerning socio-ecological barriers experience when seeking mental health care. we aimed at determining the factors that affect health seeking behavior of people with preexisting mental illness during COVID19 pandemic. METHODOLOGY: A Cross sectional study done for three months duration at Department of psychiatry, Chengalpattu Medical College and Hospital with sample size of 105. Ethical committee clearance was obtained.105 patients (age >18 years) consecutive patients having an International Classification of Disease 10 (ICD-10) psychiatric diagnosis, were included. Informed consent was obtained. Data regarding Socio demographic and clinical profile was obtained. RESULTS: In our study,39% of the patients belonged to 30-45 and 46-60 years of age, 6.7% of patients were between the age of above 60. 60% of study participants were male and the rest were female.69.5 % of patients had financial crisis ,70.5% of patients had decrease in the monthly income of the family by 30%or more.60% of patients had difficulty in travel to the hospital due to lack of transport facility during COVID pandemic. DISCUSSION AND CONCLUSION; Factors determining health-seeking behavior can help address problems and delay in early identification and optimal management of mental disorders during pandemic. Implementing community-based strategies to support resilience and psychologically vulnerable individuals during the COVID-19 crisis is fundamental for any community.

A study of factors affecting the health seeking behaviour of people with pre-existing mental illness during the COVID-10 pandemic

Health or care seeking behavior has been defined as any action undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate remedy. A little understanding exists concerning socio-ecological barriers experience when seeking mental health care. we aimed at determining the factors that affect health seeking behavior of people with preexisting mental illness during COVID19 pandemic. METHODOLOGY: A Cross sectional study done for three months duration at Department of psychiatry, Chengalpattu Medical College and Hospital with sample size of 105. Ethical committee clearance was obtained.105 patients (age >18 years) consecutive patients having an International Classification of Disease 10 (ICD-10) psychiatric diagnosis, were included. Informed consent was obtained. Data regarding Socio demographic and clinical profile was obtained. RESULTS: In our study,39% of the patients belonged to 30-45 and 46-60 years of age, 6.7% of patients were between the age of above 60. 60% of study participants were male and the rest were female.69.5 % of patients had financial crisis ,70.5% of patients had decrease in the monthly income of the family by 30%or more.60% of patients had difficulty in travel to the hospital due to lack of transport facility during COVID pandemic. DISCUSSION AND CONCLUSION; Factors determining health-seeking behavior can help address problems and delay in early identification and optimal management of mental disorders during pandemic. Implementing community-based strategies to support resilience and psychologically vulnerable individuals during the COVID-19 crisis is fundamental for any community.

Determination of cut-off and correlates of delay in treatment-seeking of febrile illness: a retrospective analysis

BackgroundEarly diagnosis and treatment of malaria symptoms reduces the risk of severe complication and malaria transmission. However, delay in malaria diagnosis and treatment is a major public health problem in India. The primary aim of the study was to determine cut-off for the delay in seeking treatment of fever, and the secondary aim was to identify the factors associated with delay in malaria-endemic areas of Assam, Northeast India.MethodsThe present study analysed data from two prior cross-sectional surveys (community- and hospital-based) that was conducted to study the health-seeking behaviour of people residing in high malaria-endemic areas of Assam, Northeast India. The hospital-based survey data were used to determine optimal cut-off for the delay in reporting, and further, used to identify the factors associated with delay using community-based data.ResultsMean age of fever cases was similar in both community- and hospital-based surveys (23.1 years vs 24.2 years, p = 0.229). Delay in reporting fever was significantly higher among hospital inpatients compared to community-based fever cases (3.6 ± 2.1 vs 4.0 ± 2.6 days; p = 0.006). Delay of > 2 days showed higher predictive ability (sensitivity: 96.4%, and ROC area: 67.5%) compared to other cut-off values (> 3, > 4, and > 5 days). Multivariable logistic regression analysis revealed that the adjusted odds ratio (aOR) of delay was significantly higher for people living in rural areas (1.52, 95%CI: 1.11–2.09), distance (> 5 km) to health facility (1.93, 95%CI: 1.44–2.61), engaged in agriculture work (2.58, 95%CI: 1.97–3.37), and interaction effect of adult male aged 20–40 years (1.71, 95%CI: 1.06–2.75).ConclusionThe delay (> 2 days) in seeking treatment was likely to be twice among those who live in rural areas and travel > 5 km to assess health care facility. The findings of the study are useful in designing effective intervention programmes for early treatment of febrile illness to control malaria.

Health Seeking Behaviour of People in a Malaria Endemic Village of Odisha, India: An In-Depth Study

Health Seeking Behaviour of People in a Malaria Endemic Village of Odisha, India: An In-Depth Study

English

This study assesses the opportunities and challenges of implementing health extension program in Shiromeda Health Center, Addis Ababa, Ethiopia. It has three key objectives: to examine prospective and retrospective views of health extension workers towards health extension program; determine the challenges faced by clients in their health service utilization and examine the challenges extension workers face during provision of services. The study employed cross sectional research design and qualitative methods. Data were collected from health extension workers and residents using interview and focus group discussions, respectively. Accordingly, while four health extension workers were interviewed, two focus group discussions, each consisting of six discussants, were conducted with members of the community based on the objectives of the study. The study found that health extension program has become a hit- or- miss phenomenon for health extension workers are fed up with the routine, tiresome work of increasing health seeking behavior of people and keeping personal hygiene and environmental health with poor salary and other compensations. Though implementation of health extension program is considered as the right action for Ethiopia, except one, all interviewees have no interest to stay as health extension workers. It is also found that on top of limited number of toilets and other health promoting establishments, politicization of formation and implementation of community based health development army has severely limited the success of health extension program. Therefore, appropriate remuneration for health extension workers; establishment of health promoting infrastructures; deployment of senior and male health professionals as health extension workers should be considered. Key words: Health extension program, health development army, health extension workers, public health, opportunities, challenges.

Longitudinal pharmacoepidemiological and health services research for substance users in treatment: protocol of the Belgian TDI-IMA linkage

BackgroundNot much is known about the health seeking behavior of people with substance use disorders before they enter specialized treatment and afterwards. This paper explains in detail the protocol that has been followed to establish the Belgian TDI-IMA-database, which is linking two separate databases: the Treatment Demand Indicator (TDI) and the database of the Intermutualistic Agency (IMA). The Treatment Demand Indicator is measuring incidence of people with substance use disorders entering drug treatment. The IMA-database covers data, collected in the framework of the compulsory Belgian health care and benefits insurance program, on reimbursed medication and the use of reimbursed health services. The linkage results in pharmacoepidemiological and health service data for people who were in treatment for substance use disorders and for a group of comparators.MethodsThe TDI-database was linked to the IMA-database for the period between 01/01/2008 and 31/12/2017, based on the national identification number of patients who have been in alcohol or drug treatment between 01/01/2011 and 31/12/2014. Through this linkage, pharmacoepidemiological and health service data became available for at least 3 years before the first registered episode in the TDI-database till at least 3 years after the first episode. For each person in TDI four comparators, who were not in specialized treatment, were matched on age, sex and place of residence.DiscussionThe TDI-IMA-database allows for an analysis of health seeking behavior and health care pathways of people before and after they entered specialized alcohol and drug treatment. The presented protocol could be used in other European countries to establish a linkage between existing health databases. This will allow for a better understanding of the health care needs of patients with substance use disorders.

Health seeking behavior and use of medicinal plants among the Hamer ethnic group, South Omo zone, southwestern Ethiopia.

BackgroundHealth seeking behavior of people around the globe is affected by different socio-cultural and economic factors. In Ethiopia, people living in rural areas in particular, are noted for their use of medicinal plants as a major component of their health care option. This study was conducted to document ethnopharmacological information of the Hamer semi-pastoralists ethnic group in southwestern Ethiopia.MethodsA cross-sectional study was carried out whereby information on demographic characteristics, prevalence of perceived illnesses, factors associated with preference of health care seeking options, medicinal plants used and hoarded as well as some healers’ socio-economic characteristics were collected using two sets of semi-structured questionnaires – one for household (HH) heads and the other for traditional healers supplemented by focus group discussions (FGDs). Households were selected using a cluster sampling followed by systematic sampling techniques; whereas healers and FGD participants were purposively selected with the assistance of local leaders and elders from the community.ResultsThe study revealed that the use of traditional medicine among the Hamer ethnic group is very high. Females preferred traditional medicine more than males. The main reasons for this preference include effectiveness, low cost and ease of availability. Malaria (gebeze) was the most frequently occurring illness in the area identified by all FGD participants. A total of 60 different medicinal plants were reported [34 by HH respondents, 14 by traditional healers and 12 by both]. Fifty-one medicinal plants were fully identified, 3 at generic level and 6 have not yet been identified.ConclusionIt can be concluded that traditional medical practices, particularly herbal aspect, is widely used by the Hamer ethnic group, although health seeking behavior of the community is affected by different socio-economic and cultural factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s13002-016-0107-x) contains supplementary material, which is available to authorized users.

Treatment of human and livestock helminth infections in a mobile pastoralist setting at Lake Chad: Attitudes to health and analysis of active pharmaceutical ingredients of locally available anthelminthic drugs

Mobile pastoralists face challenges in accessing quality health care and medication for managing human and animal diseases. We determined livestock disease priorities, health seeking behaviour of people bearing helminthiases and − placing particular emphasis on trematode infections − treatment strategies and outcome satisfaction among mobile pastoralists of four ethnic groups in the Lake Chad area using focus group discussions. People suffering from schistosomiasis were interviewed about symptoms, health seeking behaviour and their satisfaction with respect to the provided treatment. Anthelminthic drugs for human and veterinary use obtained from various health care structures were analysed for active pharmaceutical ingredients (API) and quantity, using high pressure liquid chromatography-UV and liquid chromatography combined with tandem mass spectrometry. Most people suffering from schistosomiasis sought treatment at health care centres. Yet, they also consulted informal providers without medical training. Regarding animal health, self-mediated therapy was common to manage suspected livestock fascioliasis. Self-reported treatment satisfaction for human schistosomiasis and trematodiasis treatment outcome in livestock were low. Mobile pastoralists perceived the purchased drugs to be of low quality. Among 33 products locally sold as anthelminthic drugs for human or veterinary use, 27 contained albendazole or mebendazole, varying between 91% and 159% of the labelled amount. Six products were sold loosely with incomplete information and their API could not be identified. No counterfeit anthelminthic drugs were detected. None of the samples contained praziquantel or triclabendazole, the drugs of choice against schistosomiasis and fascioliasis, respectively. The perceived unsatisfactory treatment outcomes in humans and animals infected with trematodes are most likely due to empiric diagnosis and the resulting use of inadequate therapy for human schistosomiasis and the lack of efficacious drugs against livestock fascioliasis.

Utilization of health care services in rural and urban areas: a determinant factor in planning and managing health care delivery systems.

Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.

“What do I know?” Scholastic fallacies and pragmatic religiosity in mental health-seeking behaviour in India

This paper draws on ethnographic fieldwork on psychiatrists and their patients (their care-givers and their communities) in North India. It addresses the questions as to when and why people approach psychiatrists and religious healers by arguing that approaches assessing “explanatory models” and other knowledge structures relevant to the people's health-seeking behaviour should place more emphasis on the people's strong desire to get well, in any way possible. Secondly, the difference between beliefs rooted in the patients’ life-worlds and explanations suggested to them by experts has to be acknowledged. These insights motivate a shift away from the concept “religion” towards the differentiation between pragmatic and scholastic religiosities. This argument relates back to the Greek meaning of “pragma” understood by Hans-Georg Gadamer as “that within which we are entangled in the praxis of living”.

Health-seeking behaviour for febrile illness in malaria-endemic Kolasib district, Mizoram, India

Early diagnosis and complete treatment (EDCT) is an important strategy for malaria control in India's National Vector Borne Disease Control Programme. The success of this strategy is closely linked to people's health-seeking behaviour. A study was conducted to determine the treatment-seeking behaviour of suspected malaria patients in Kolasib, a highly malaria-endemic district in Mizoram, India. Approximately one-third of the 540 fever patients interviewed sought initial treatment from public health facilities, whilst the majority either took self-treatment or purchased medicines from private pharmacies. Approximately 20% of patients sought treatment after 48 h of fever onset. Patients aged >14 years and those who had an income ≥Rs 5000 (US$104) were more likely to receive treatment from non-governmental health facilities. Patients aged >14 years and those residing in difficult locations were more likely to take treatment after 48 h of fever. To improve implementation of the EDCT strategy, it is necessary to conduct health education campaigns in the district (i) about seeking early treatment from public health facilities, including the fever treatment depots established in all villages, and (ii) discouraging the practice of self-treatment.

Declining Free Health Care and Rising Treatment Costs in India: An Analysis of National Sample Surveys 1986–2004

The article focuses on trends in health-seeking behaviour of people and choosing between government and private sources, reasons for not accessing health care and the cost of treatment by examining three rounds of NSS data on health care use and morbidity pattern during 1986–87, 1995–96 and 2004. With variation across states, treatment-seeking from public providers has declined and preference for private providers has increased over the period. Although overall health-seeking behaviour has improved for both males and females, a significant percentage of people, more in rural than urban areas, do not seek treatment due to lack of accessibility and consider that the illness is not serious enough to require treatment. The financial reason for not seeking treatment was also an important issue in rural areas. There has also been change in the cost of health care over time. While the health care cost has increased, the gap between the public and the private has reduced, owing to perhaps increased cost of treatment in public health facilities following the levying of user-fees and curtailing distribution of free medicine care. Practically all states reported decline in availability of free both out-patient and in-patient care. The article concludes with supporting the adaptation of innovative public-private partnership in health sector for various services realizing the limitations of the state provision of health, particularly in rural and remote areas, and the growing preference of consumers for private health providers. As effectiveness of public spending also depends on the choice of health interventions, target population and technical efficiency partnering with private health providers could work towards reducing the health inequalities in the country.

Self-medication practice among patients in a public health care system

A survey of 500 patients attending primary health care centres in Riyadh, Saudi Arabia was carried out to determine the prevalence and factors associated with self-medication practice. The results indicated that 35.4% of the respondents had practised self-medication past 2 weeks. Bivariate and multivariate analyses indicated that respondents who were young, male, having poor health status, reporting inconvenient access or dissatisfied with health care were more likely to practise self-medication. Health education campaigns, strict legislations on dispensing drugs from private pharmacies and increasing the quality of and access to health care are among the important interventions that might be needed in order to change the people's health seeking behaviour and protect them from the potential risks of self-medications.