Health Seeking Behavior

This work may be relevant to other contexts in which a technology is under-adopted due to stigma. In particular, if a technology dispro- portionately benefits a stigmatized group, it may be under-adopted, as individuals know it will signal their underlying type. For example, a per- son who suffers from mental illness may be reluctant to seek psychiatric care, for fear his friends or employer might find out. Stigma, in many contexts, may be explained by statistical discrimination; employers might believe that the mentally ill are less productive workers. This situation leads to a bad equilibrium: the employee’s mental illness goes untreated, and he is less productive than he would be if he were receiving treatment. Of course, one solution is to help the employee obscure the signal, by ensuring privacy of psychiatric care. However, if statistical discrimination is based on incorrect beliefs, providing correct information to the public, or in this example, to employers, should eliminate the stigma equilibrium. A community-level information campaign on the public benefit of ART drugs is an inexpensive way to reduce stigma and increase HIV testing. A policy which reduces stigma directly is more attractive than one which helps HIV test-seekers conceal their decision to test or their motivation for testing. For example, while monetary incentives increase HIV testing, in order to be effective in the face of stigma, they must be paid repeatedly to the entire community. This might make monetary incentives for ART use infeasible. A reduction in the level of stigma should affect all health seeking behavior, and have permanent effects.

An observational cross-sectional study was conducted at Mymensingh district to explore hygiene practice and health seeking behavior of aged Garo ethnic people. Face to face interview was carried out and convenient sampling technique was used to collect data and verbal consent was taken from community leader prior to interview. About 60% respondents were from 60-69 years age group. Male and female distribution was nearly same. Illiteracy was highest (38%) followed by primary (34%) and SSC (20%). About half of the respondents were housewife followed by day labor (18%), farmer (14%), service (10%) and business (8%). Two third of respondents came from low income family. All of them washed hand before taking food and after toileting. More than two third of them used only water before taking food and 80% used after toileting. Most of them (88%) did not cut nail regularly. More than half of the respondents had musculoskeletal problem. Seeking consultation from Govt hospital as well as rural medical practitioner/traditional healer/pharmacy man were nearly same. Hygiene practice and health seeking behavior was not satisfactory. Accessibility to Govt hospital need to be increased.

In regard to gender distribution, our study showed IBS to be more associated with the female gender (54.3%) as compared to the male (45.7%) and this was statistically significant (p = 0.019). Gender difference in IBS prevalence is well established. Generally, the Female/Male ratio of IBS approaches 2:1 but within the population of patients that seek consultation with primary care physicians the ratio is as high 3:1 [27]. In most populations, women tend to report more IBS symptoms than men irrespective of the diagnostic criteria employed [4-6]. This gender difference in the prevalence of IBS could be due to differences in gender-related illness perception and health-seeking behavior. It could also be due to gender-related physiologic and psychological differences.

The current study will draw on concepts from the Behavioral Model of Health Services Use, which has been extensively used to describe the complex series of steps that individuals take towards health care, to highlight the individual- and contextual-level factors that can act as barriers in the complex process for seeking care at health facilities [6, 7]. Various factors influence health-seeking behavior, such as an individual’s socio-demographic char- acteristics, their awareness of existing services, and their perceptions of those services, as well as cultural norms, disease patterns, and characteristics of the local health ser- vices system, including its personnel [8]. Previous studies have demonstrated a well-established link between socio- economic status and health, including health prevention, household sanitation, diet, and utilization of health ser- vices [9–20]. Maternal education is also a reoccurring significant social determinant associated with maternal and child health and health care use [21–23]. Additionally, a lack of sufficient recognition of local customs and indi- genous medical practices by the health service providers can influence the use of government-provided health ser- vices [24, 25]. With regards to the local health care system, the access costs of health services (monetary and time) can be a significant burden for impoverished populations and a barrier to their utilization. Furthermore, attitudes and behaviors of health care providers in these facilities can influence health-seeking behavior by the local popula- tion. Behaviors such as verbal abuse, neglect, absenteeism,

Principle-based ethics appears to be recent addition to Sub-Saharan Africa’s rights profile, although universal principles of morality have been part of the region from time immemorial. In this regard, periodic review of how principle-based ethics is being integrated into the health-seeking behavior of Sub-Saharan Africa is essential to the capabilities and functionings of the people. Whether the Hohfeldian incidents should be applied to Sub-Saharan Africa in measuring the degree of autonomy, ca- pacity and informed consent, given the limited actual and medical education. Whether ethical concepts of “responsibility” and “paternalism” should be more promoted and if so, what happens to their “functionings” and “being”? The author examined the literature on ethics, searched databases for reports and published pa- pers in the English language. Hand searching of selected printed journals and grey literature such as technical reports and conference proceedings were also accessed and briefed for further analyses. This shows that Hohfeldian rights are a natural part of African ethics. Principle-based ethics does not incorporate African ethics per se, although physicians’, and decision experts’ paternalism enhances the health-seeking behavior of Africa’s people, it interferes with their “rights”, “claims”, “power” and “privilege”, as well as their capabilities and functionings. Hohfeldian rights relate to Sub-Sahara Africa as universal man and amalgamate with African ethics and morali- ty through the paternalism of doctors, community leaders and other “decision ex- perts” in society in general. The application of the principle-based ethics in the healthcare delivery system and in other endeavors of Sub-Saharan Africa is achieved through the paternalism of superior powers. This compromises the functionings and being of the people.

The purpose of the present study was to investigate health-seeking behavior in the health science literature in order to identify its attributes, antecedents and conse- quences of concept. Results obtained from our study revealed that important attributes of health-seeking be- havior concept are interactive and process (health-seeking behavior is a social process, it not only involves individ- uals’ interactions with the social network [30] but also is a social action involving other individuals), intellectual (peo- ple’s noticeable desires to health control and their con- cerns about environmental impacts on the health [32] which differs from person to person and culture to cul- ture), active (actively searching for ways to change his/her health habits or environment to move toward a higher- level wellness) and decision making based (health-seeking behavior is making decisions about health choices [14] or processes that affect health status [38] as well as focusing on patterns of decision-making [15] decisions and related responses and ability to measure has been tested using quantitative (KAP studies, surveys and cross-sectional studies) as well as qualitative research methods (ethnog- raphy and Narrative studies) dimensions. Health-seeking behavior antecedents include social, cultural, and eco- nomic and disease patterns and issues related to health services. Hence, policy makers should pay great attention to provide access to health services in social, cultural and economic contexts for all society members. Consequences of such strategies would be health promotion, disease risk reduction, prediction of the diseases burden, facilitation of health support, early diagnosis, effective treatment, com- plications control and the last but not the least designing and implementation of the required services. The results of the concept analysis are important as they lead to integration and synthesis of the concept.

We developed an integrated mathematical model by incorporat- ing the epidemiological transmission dynamics, the informa- tion flow of human responses, and an information theoretic model to assess the effects of network-driven risk perception on influenza infection risk. The simulated human responses with perceived health behaviors could decrease the risk of infection among different age groups. We demonstrated that the risk perception among populations changed with the effective information varying with the contact numbers of individual. We conclude that the present integrated BI model can help public health authorities on communicating health messages for an intertwined belief network in which health-seeking behavior plays a key role in controlling influenza infection.

among her children. Nevertheless, we believe that the findings in this study will be of importance to providers and health policy planners in developing countries. Second, this study does not explain why women tend to invest more in first-order births than higher-order births. Possible explanations for this behavior might include the potential role played by time and financial constraints inhibiting mothers to invest more in the health of their children [36]. Furthermore, women might learn from previous pregnancy experiences. For instance, a woman might realize that breastfeeding might be more time consuming and costly that she might decide not to breastfeed the next child [37]. Knowledge and explanations of why women lower investments in maternal health-seeking behavior across birth order will be relevant to providers and public health policy makers in their quest to encourage the use of maternal health services among women of higher-order pregnancies. Lastly, the analysis in this study does not control for potential self-selection bias which has been found to bias the results. However, despite all the above limitations, this study provides important insights regarding maternal health-seeking behavior and child well-being and thus makes an important contribution to the body of literature.

Background: Psychiatric illness is a mental disorder or mental illness which is defined as mental or behavior pattern that causes either suffering or poor ability to function in ordinary life. Such features may be persistent, relapsing & remitting or occur as single episode. Typically social norms & religious or cultural beliefs are excluded. Causes of psychiatric illness are unclear. Mental or psychiatric disorders are usually defined by combination of how a person feels acts, thinks or perceives. Objectives: To assess the knowledge of health seeking behavior among psychiatric patients. Methodology: Study Design:Cross-sectional study. Setting:Sheikh Zayed Medical College/Hospital RYK (Psychiatric Ward and OPD)Duration:A period of Three months from 15 th February to 15 th May 2017. A predesigned and pre-tested questionnaire was used for data collection.Subjects of study were all the patients who were suffering from Psychiatric illness between 18-65 years of age and of either sex.A total of 58 consecutive patients were included in the

Abstract: Health literacy is a measure of the patient’s ability to read, comprehend and act on medical instructions. This research article examines health literacy and health-seeking behaviors among elderly men in Jamaica, in order to inform health policy. This is a descriptive cross-sectional study. A 133-item questionnaire was administered to a random sample of 2,000 men, 55 years and older, in St Catherine, Jamaica. In this study, 56.9% of urban and 44.5% of rural residents were health literate. Only 34.0% of participants purchased medications prescribed by the medical doctor and 19.8% were currently smoking. Despite the reported good self-related health status (74.4%) and high cognitive functionality (94.1%) of the older men, only 7.9% sought medical care outside of experiencing illnesses. Thirty-seven percent of rural participants sought medical care when they were ill compared with 31.9% of their urban counterparts. Thirty-four percent of the participants took the medication as prescribed by the medical doctor; 43% self-reported being diagnosed with cancers such as prostate and colorectal in the last 6 months, 9.6% with hypertension, 5.3% with heart disease, 5.3% with benign prostatic hyperplasia, 5.3% with diabetes mellitus, and 3.8% with kidney/bladder problems. Approximately 14% and 24% of the participants indicated that they were unaware of the signs and symptoms of hypertension and diabetes mellitus, respectively. The elderly men displayed low health literacy and poor health-seeking behavior. These findings can be used to guide the formulation of health policies and intervention programs for elderly men in Jamaica.

Results: Participants had very low awareness of cervical cancer. However, once the symptoms were explained, participants had a high perception of the severity of the disease. The etiology of cervical cancer was thought to be due to breaching social taboos or undertaking unacceptable behaviors. As a result, the perceived benefits of modern treatment were very low, and various barriers to seeking any type of treatment were identified, including limited awareness and access to appropriate health services. Women with cervical cancer were excluded from society and received poor emotional support. Moreover, the aforementioned factors all caused delays in seeking any health care. Traditional remedies were the most preferred treatment option for early stage of the disease. However, as most cases presented late, treatment options were ineffective, resulting in an iterative pattern of health seeking behavior and alternated between traditional remedies and modern treatment methods.

There were 695 snakebites in the survey sample and 13 had not sought treatment. There- fore, 682 victims’ data was used for the model. Health seeking behaviour (i.e. allopathic treat- ment seekers vs indigenous treatment seekers) was considered as the response variable, where those who sought allopathic treatment were coded as 1 and others were coded as 0. Separate binomial logistic models were used to evaluate the differences in health seeking behavior in different provinces, and to identify the variables associated with individual decisions on select- ing the treatment type. In the first binomial logistic model, province was considered as an independent variable, where allopathic treatment seeking behavior was compared between provinces. Western Province, which had the lowest proportion of people seeking allopathic treatment was considered as the comparator (i.e. the reference level). Odds ratios with 95% Confidence Intervals were generated to illustrate the differences in health seeking behavior in each province with reference to Western Province. A second binomial logistic model was used to investigate the association between health seeking behavior (i.e. allopathic vs traditional) and socio-demographic variables of victim, envenoming status of victim, time of bite, month of bite, place of bite, identification of snake, distance from the bite location to the healthcare facility where the initial treatment was obtained, outcome of the bite and incidence of snake- bite or envenoming at the geographical cluster level. Adjusted Odds ratios with 95% Confi- dence Intervals for the significant variables were obtained and a p value of 0.05 was considered as significant. Data analysis was done with R programming language version 3.2.3 and geo- graphical mapping was done with ArcMap 10.3.1.

Before data collection a detail workout of study was discussed with in-charge of CBO in urban slum. Informal meeting was conducted among bar girls to explain objective of study and assurance about confidentiality was given. Data was collected by one to one interview method by using pre-tested questionnaire. Information was gathered regarding demographic profile, educational status, marital status and health seeking behavior of bar girls. Data was compiled, tabulated and analyzed using chi square test and logistic regression method.

The finding of this study shows that women empowerment increases their health seeking behavior and should be recognized as a norm and an important component in health systems design. Religious misperception should be removed so that women can move outside the home along with increased participation in working. Media campaign and inclusion of religious leaders at the local level may help to disseminate messages for women rights and empowerment. Measures should be taken to increase education capacities for both men and women and ensure that no woman marry before age 18 years. Women’s workforce participation should be increased so that women can be self-dependent financially. Finally, consideration should be given on male participation not only in maternal healthcare service utilization but also in every aspect of conjugal life so that a culture of discussion between husband and wife about the family matters can be ensured.

The study investigates the associations between domestic violence and women’s empowerment and women’s health seeking behavior in Pakistan. The result showed that how domestic violence affects women’s decision making power and their health seeking behavior. The research reveals that ANC visits more than 5 visits; pregnancy loses more than once, women with STI in the last 12-month and households in which money is a big problem for treatment are positively associated with domestic violence. Kabir and Khan (2013) reported that education helps to increase the awareness level for the use of ANC service [18]. Women who ever had vaccination are not statistically associated with domestic violence. This shows that women who were abused by physically and emotionally at home were less likely to use up the antenatal care services. This is consistent with other researches in Tanzania, Nepal and in India which shows that domestic violence is associated is less ANC visits during pregnancy time [19,7, 20]. Result suggests that maternal death rate was high in the United Kingdom due to lack of antenatal care visit [21].

education and income. By lumping these variables together as one construct, prior studies have not provided enough insight into possible independent associations with health outcomes. This study used data from the 2008 Ghana Demographic and Health Survey from women aged between 15 and 49 years to examine the association between household consumer durables (a component of SES) and maternal health seeking behaviour (MHSB) in Ghana. Results from a set of generalized linear models on a sub-sample of 2,065 participants indicate that household consumer durable assets are positively associated with antenatal practices such as seeking prenatal care from skilled health personnel, delivery by skilled birth attendant, place of delivery, and the number of antenatal visits. The study discusses implications for health interventions and policies that focus on most vulnerable households.

Table 1 shows age group distribution and prenatal care status of patients presenting with UCP from 1995 to 2005 at the University College Hospital, Ibadan, Nigeria. It shows that the age of the patients varied between 15 years and 40 years, and that the highest prevalence was in the 25–34-year- old age group. The mean age was 29.2 years. There were 54 patients (75%) without prenatal care by trained health care personnel, and 18 patients (25%) with prenatal care who had UCP and were treated in the labor and delivery facilities of University College Hospital, Ibadan, during the study period.

In terms of access to health information, whereas the average patient in the western industrialized nation has access to many sources of health and other information, the same cannot be said about a patient in Ghana or elsewhere in Sub-Sahara Africa. The average westerner gets health education directly and indirectly through television and syndicated shows like, “ER”; “Grey’s Anatomy”; “Dr. Oz”; or the “Doctors”, the inhabitants of the developing world hardly receive health information except at the hospital or clinic. When there are television shows, they are often in the English language that naturally excludes millions of listeners who do not understand the language. Although it is easy to take for granted that television is in every home in nations like Ghana and Niger, the reality is quite shocking. For example, in 2002, Ghana ranked 143th with 26% penetration on the list of nations with television saturation in homes. Niger ranked 174th with only 5.4% penetration of televisions to homes. About every ten people share one set of television, it is generally estimated (www.nationmaster.com, 2014). This does not mean to suggest that the patient in Ghana does not know and cannot tell his physician what ails him. What it really means is that the average patient in Ghana and elsewhere in Sub-Sahara Africa depends on his physician as the main source of medical information.

were conducted in an open manner, with no explicit focus on the political conflict with Israel. Respondents could raise the point, if they wished to do so, but were not repeatedly probed to do so. The authors purposely selected this strategy, because they felt that all that is disseminated and therefore known on the oPt revolves around the conflict, with little attention being paid to other dimension of everyday life. Women did not insisted on the role of the conflict in mediating their health seeking decisions in an explicit manner, but ra- ther allowed it to appear in between the lines when rec- ognizing the limitations of their health care system. This is probably an indication that they are accustomed to the situation, potentially having lived their entire life with the conflict in the background, to the extent that they no longer recognize its explicit role in shaping their health seeking decisions. The most likely interpretation is that socio-political unrest molded and continues to mold the features of the health care system, as described in the introduction, but not necessarily people’s everyday decisions on health seeking, at least not on a conscious level.

Another interesting finding was that the majority of the respondents preferred to seek treatment in the health facilities rather than approaching traditional healers and self medication. This may be due to the fact that the Serbo health center is located within the study area as result accessibility is extremely high among the local inhabitants. In addition, it’s providing services free of charge. The present study findings are comparable with few earlier studies. In Ethiopia, 98% respondents had their first visit to health care facilities including public and private health services as well as malaria control laboratories, drug venders/pharmacy and CHWs seeking treatment for malaria [17]. Another study in Swaziland found that almost 90% of the respondents seek treatment in the health facilities [15].