Health seeking behavior among women in Bhimtar, Sindhupalchowk district of Nepal

Abstract

INTRODUCTIONHealth seeking behaviour is 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.1 When assessing and monitoring the health of a population, it is important to describe not only classical mortality and morbidity indicators but also, perceived illness visits to primary health services and utilization of the healthcare services provided.2 Final report of MDG shows that Nepal has made notable progress in health outcomes but still general health status of women (especially those in reproductive age) in Nepal is still poor.3 Poverty, illiteracy, women's low status in the society, lack of access and difficult geographical terrain are major reasons for poor health status of women in Nepal. 4 Despite the increase in service delivery in our country (FY 70/71), people are still not utilizing it properly due to different reasons. 5 The first choice of the people in the community is still traditional practices which include ABSTRACT Background: When assessing and monitoring the health of a population, it is important to describe not only classical mortality and morbidity indicators but also, perceived illness, visits to primary health services, and utilization of the healthcare services provided. Objectives of the study were to determine the health status and factors affecting health seeking behaviour of women. Methods: A descriptive study was done at Bhimtar, Sindhupalchowk District in Nepal, involving 147 subjects sampled by purposive sampling. Study population consisted of women. Data was collected by house to house interview with pretested questionnaire during month of September 2016. Data was entered and then analysed using Statistical Package for the Social Sciences (SPSS) 20. Simple measures of statistics like frequency, percentages, means were used to represent the data in tables as a part of descriptive analysis and chi-square test was applied to see the association with dependent variables. Results: Among 80.9% women who had gynaecological problems, the highest prevalence rate of the disease was low back pain (60.5%) followed by lower abdominal pain (35.2%), dysmenorrhea (27.3%) and menstrual irregularities (27.3%). The first approach of seeking health for the reported illness among women was the traditional healer (51%). Regarding attitude towards modern medicine, 47.6% respondents replied that facilities were not available locally. Similarly regarding hindering factors for not utilizing health services, lack of female doctors (43.75%) and far distance of health care centre (37.5%) were the most common ones. Conclusions: Higher percentage of women in Bhimtar sought after the traditional healer as the best way for utilizing health services. Modern health care utilization was less because of the distance to be covered during illness and lack of doctors in the health centre.

Prevalence and Factors Associated with Health Services Utilization of Sindhupalchowk District, Nepal

“…Similar study done in Eastern Hilly Regionand in Bhimtar, Sindhupalchowk Districts found that basic demographic factors did not show any association in bivariate analysis in choosing between traditional and modern methods. 3,6 But in this study, only education, duration of stay at this locality and type of disease showed association at 95% level of confidence (p<0.05).…”

“…9 In my study, almost 90% there were not available of the health worker, medicine and equipments in government health facilities.The main reason for not utilizing health services were lack of female doctors (43.75%), no lab facilities (31.25%), lack of doctors (25%) and lack of medicine(25%) in the study in Bhimtar, Sindhupalchowk district of Nepal. 6 In this study affordability and availability of care provider were found to have significant association with utilization of health services. Therefore, from above discussion we can conclude that affordability and availability is key issue in seeking health services.…”

“…Hindering factors for the utilization of health services are far distance of health care centre (35%) in the study in Bhimtar, Sindhupalchowk district of Nepal. 6 This study found association between distance of health facilty and means of transportation with utilization of health services at 95% level of confidence (p<0.05). But similar study done in Eastern Hilly Region demonstrated that no association was found between distance of health facility and means of transportation and choice of treatment systems (modern and traditional).…”

“…5 My study found that majority of the respondents (63.1%) first visited modern health services but this result has been found to be in contrast with a study done in Sindhupalchowk district, majority of respondents 51% seek traditional healer for the illness. 6 Such difference may be due to different study population. However similar findings as my study were showed in studies done in Eastern Hilly Region of Nepal and Northwest Ethopia.…”

“…11,4 The study also revealed the hindering factors for health seeking behavior that are doctors not available (25%), lack of medicines (25%), no lab facilities (31.25%), costly (37.5%), no female doctors (43.75%), and too far to reach (35%). 6 A study conducted in Chatara Vdc in Bajura District found that health worker donot visit home of people during illness and if they visit, they donot come in time,additionally, they take high charge. So most of the peope were attracted towards traditional health services.…”