The informal health sector and health care-seeking behaviour of mothers in urban Dhaka slums

Abstract

Infant and child mortality in Bangladesh has declined in recent years but early death rates remain high among Bangladesh's urban poor, even in comparison to rates in rural Bangladesh. Although they live close to the country's leading public hospitals and private health clinics, the urban poor continue to rely heavily on services and advice provided by the informal health sector. This paper examines the use of the informal health sector by urban poor children's main caregivers, their mothers, and the key role performed by pharmacists in treating these children. It explores the nature of the relationship between the mothers and the health providers and the implications for the broader health system. The study combines in-depth interviews with survey data.

The economics of healthcare access: a scoping review on the economic impact of healthcare access for vulnerable urban populations in low- and middle-income countries

“…Another important element that influences healthcare expenditures is the growing trend in the use of private services through non-governmental organizations and informal providers in slum settlements [ 17 , 126 , 127 ], which may lead to the high cost of care for acute conditions for slum-dwellers. This trend was observed for obstetric care in Nairobi, Kenya where women residents of poor settlements were more likely to give birth in private services compared with women residents of better-off settlements [ 127 ].…”

“…The poor access to the formal health sector, multiple health providers used by slum residents over long periods, and choices and preferences for healthcare providers also affect healthcare expenditures [ 17 , 128 , 129 ]. A study conducted in Brazilian slums found that the formal sector reaches the vulnerable slum residents with a deteriorated health status due to the lack of adequate assistance during the initial stages of illness.…”

“…The rapid and uncontrolled urbanisation that has characterised LMICs and the resultant disparities in economic conditions has led to widening health and wellbeing inequalities [ 14 , 15 ]. Changes in living conditions and health-seeking behaviours, coupled with insufficient access to quality healthcare undermine the opportunities for city residents, particularly slum-dwellers, new migrants and low-income households whose unstable and informal working lives present further challenges to access appropriate quality care and keeping healthy [ 16 , 17 ]. The limited provision of public primary care, the number, range and complexity of private providers [ 18 ] and the wide variations in the quality of healthcare provision in cities present significant challenges to effective health-seeking behaviour[ 19 ].…”

Untitled

“…Evidence showed that 82.4% of slum dwellers received health care from informal providers [10,11]. Healthcare utilization from informal providers can have adverse effects on health because of non-guideline-based treatment and overuse of drugs [12,13].…”