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Introduction: During menopause, women experience various psychological or physical changes which need adequate attention. Moreover, women don’t seek help for these problems due to their hesitancy, lack of awareness, socio-cultural, financial constraints or as they feel this is a natural-phenomenon. The study aims to explore the postmenopausal experiences faced by women during menopause and to elicit the constraints faced by them in seeking health-care services. Methodology: This was a qualitative study with phenomenological approach conducted among post-menopausal women (≥45 years) from Oct 2022-Jan 2023 with the help of In-Depth-Interview guide in four villages of Bhatar Block, Purba-Bardhaman District. Considering the availability of the study participants, they were selected purposively from the list prepared by ASHA of each village and recruitment done till the point of data-saturation. Inductive thematic-analysis was used to identify codes and themes. Results: During menopause, women experienced physical and psychological changes in the body, changes in social life and for these changes they had to adjust to cope-up. They felt various needs like empathy from hus-bands, children, peers. On the other hand, they did not seek help from health-care services due to their knowledge gap, dissatisfaction from previous-visit, cost-issue and unavailability of resources in health-care delivery system. Conclusion: Majority of the post-menopausal women faced various problems associated with menopause, but very few had sought help. So, health care providers have an important role to generate awareness among post-menopausal women regarding physical and mental changes during this phase.
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Background: Adolescent girls are often less informed and less comfortable in accessing reproductive health care and information. Due to taboos and socio-cultural restrictions associated with menstruation and its issues, a culture of silence surrounds it. Every stage of women’s life influences next stage, thus present menstrual health will help the girls to have good reproductive, sexual and maternal health later. Good knowledge and better health care seeking behaviour will help in managing menstruation hygienically and with dignity. Hence the present study was undertaken with the objectives, to assess knowledge about menstruation and to determine health care seeking behaviour for menstrual health among adolescent girls in urban slums.Methods: A cross sectional study was conducted to assess knowledge about menstruation and determine health seeking behaviour for menstrual health among 150 adolescent school girls. Multi stage random sampling with probability proportionate to size sampling technique was used. A pre-tested, semi-structured questionnaire was self administered to assess socio-demographic factors, knowledge and health care seeking behaviour for menstrual health.Results: Among 150 adolescent girls, 102(68.0%) of them had good knowledge. Among girls who had excessive bleeding and irregular menses only half of them sought medical treatment (p<0.05) and though 59.5% had more than one symptoms in a cycle, only 37.3% sought treatment.Conclusions: Health care seeking behaviour for menstrual health among adolescent girls was marginally low, only 34(37.4%) sought treatment.
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Background: The persistence of severe intra-partum events as causes of perinatal mortality may be due to the poor care pregnant women receive in labour. The quality and scope of care received in labour varies with the types of health facilities patronized. Objective: To describe the obstetric care-seeking behaviours of pregnant women in Sagamu, Nigeria and relate this to the perinatal outcome. Methods: A cross-sectional survey of parturient at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria was conducted between August 2013 and November 2014. Data were obtained on the demographic and obstetric profile, details of facilities visited during labour and perinatal outcome for analysis. Results: Out of 145 women, 93 (64.1%) received antenatal care at OOUTH. Of the 84 women who were first admitted in labour, 32 (38.1%) presented with emergencies. There were 140 live births and 10 still births; 34/140 (24.3%) of the live births were hospitalized mostly with asphyxia (13/34; 38.2%). One of the 34 hospitalized babies died from asphyxia thus the overall perinatal mortality rate was 73.3/1000 births. Women who presented with emergencies during labour and traversed other health facilities while in labour characteristically had low maternal education, low socioeconomic status and received antenatal care outside OOUTH. Poor perinatal outcome was significantly associated with unbooked status, presentation with emergencies during labour and traversing other health facilities in labour. Conclusion: Quality antenatal care and timely presentation during labour may influence perinatal outcome positively. Research should be focused on strengthening the existing health care structure.
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Background & objectives: Inequity in the use of health care services is an important factor affecting the maternal and child survival. In southern Odisha, India, the health indicators remained below compared to the state and national average. This study identifies various equity issues at individual and community levels that influence women’s choice affecting the utilization of maternal health services in a district in southern Odisha. Methods: A qualitative study was carried out in Gajam district, rural region of south Odisha. Ten in-depth interviews were carried out till data saturation with women having less than one year child and 10 focus group discussions with the average eight women in each group having less than five year old child, community and health care providers separately. A total of 120 respondents were included in the study using in-depth interview and focus group discussions. Results: The important determinants in utilization of health care services by women emerging from the study were transportation and financial constraints. In addition, it was found that divergent aetiological concepts and low perceived hospital benefits of the women and community were equally important determinants. Further, community had different perceptions and interpretations of danger signs influencing the risk approach and health care seeking behaviour. Interpretation & conclusions: Our findings show that to increase the utilization of health care services, the grass root health workers should be made aware of specific social determinants of risk, perceptions and preferences. more attention should be given to the transportation system, and its operational feasibility. The husband of the women and the elders of the family should be considered as an important unit of interjection. A more individualized antenatal consultation could be provided by taking into account women’s perception of risk and their explanatory models.
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Background: Designing health care policies and programmes requires knowledge about health care seeking behaviour, so that appropriate interventions can be implemented. Health care seeking behaviour is influenced by the individual self, diseases, and the availability and accessibility of health services. Dependent on these determinants health care seeking behaviour is a complex outcome of many factors operating at various levels. Aims & Objective: Present study aimed at exploring possible differences in health care seeking behavior in rural and urban Ahmedabad. Material and Methods: A Cross-sectional study was carried out over a period of one year (April 2011-March 2012) in urban and rural area of Ahmedabad district. Total 500 houses from each were surveyed using pre-designed and pre-tested proforma by house to house visits. Head of the family from each household was interviewed. Information regarding morbidity and health seeking behaviour was collected during household survey. Results: Maximum number of respondents belonged to age group 25-39 years in urban (49.8%) and rural (53.8%). Rural people preferred government and trust hospitals (51.1%) more as compared to urban (44.1%). Significant difference was observed in place for treatment of acute illness from faith healers. More rural people (29.2%) took treatment from faith healers than urban (22.8%). Majority of rural people (59.6%) took treatment for chronic illness from private practitioner than urban (51.4%). More urban people (57.4%) were using cash savings for treatment than rural people while borrowing and selling assets for treatment was more in rural people (57.4%) The result was statistically significant. Insurance coverage for illness was significantly low both in urban and rural area. Conclusion: Difference in health seeking behaviour was noticed among urban and rural communities. As far as treatment of chronic illnesses is concerned more infrastructure investments should be made to improve accessibility to government health care facilities, especially in rural areas. There is a need to make the rural people more aware regarding availability of various health insurance schemes.
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Background: Little information is available on triggers and barriers for seeking appropriate healthcare among chest symptomatics (CS) from slum populations in India. Methods: Urban slums in Uttar Pradesh (UP) and Karnataka (KA) were selected based on case detection rate (2008), population size and geographic distribution. A door-to-door survey was conducted in 2010 and CS were identified and interviewed. Action taking patterns were collected and factors influencing these among behavers (CS visiting qualified providers) and non-behavers (CS not taking action or resorting to self-medication) compared. Results: Of 1526 CS in UP and 1515 in KA interviewed, 75% in UP and 58% in KA sought care; of them 79% in UP and 99% in KA visited a qualified provider. More than 80% in both UP and KA underwent recommended tests within a week (mean days: UP-1.8; KA-2.4). Only 16% of respondents in UP and 48% in KA reported that private qualified providers recommended sputum microscopy. Important triggers of visiting a qualified provider were being females; of higher economic status, self-efficacy, suspicion of having TB when suffering from persistent cough and that sputum microscopy should be done to diagnose TB. Additional triggers included knowledge that TB is caused by germs and can affect anyone (UP) and perceptions of quality of care and knowledge that TB is curable (KA). Implications: There is need to carry out targeted area-specific communication in slums to improve appropriate treatmentseeking behaviour and demand creation for DOTS by CS. The study recommends investments to focus on changing private provider behaviour.
Subject(s)
Adult , Aged , Directly Observed Therapy , Female , Health Knowledge, Attitudes, Practice , Humans , India/epidemiology , Male , Middle Aged , Patient Acceptance of Health Care , Population Groups , Poverty Areas , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/epidemiology , Young AdultABSTRACT
Background: World population ageing is enduring, the proportion of older persons has been rising steadily, from 7 per cent in 1950 to 11 per cent in 2007, with an expected rise to reach 22 percent in 2050. Globally the population of older persons is growing at a rate of 2.6 per cent per year, considerably faster than the population as a whole which is increasing at 1.1 percent annually. The issue of health care-seeking (or medical-care) behaviour is crucial to all society. Objective: To know the Socio-demographic distribution of elderly population in rural area, observe the Health seeking behaviour of the rural elderly and to know the available health care services in rural area of Uttar Pradesh. Materials and Methods: A community based Cross sectional study was conducted from October 2010 to June 2011. Persons aged 60 years and above were selected by multistage random sampling. The minimum Sample size of 400 was calculated using formula 4pq/d2 and finally a total of 411 individuals were studied. The data was analyzed by means, proportions and Chi-square test, p value less than 0.05(p<0.05) at 95% confidence interval, was consider for significant, SPSS Version 12 Statistical Software was used to analyze the data. Results: Out of the 411 elderly persons, 214 (52.1%) were males and 197(47.9%) were females. Mean age for the entire study population was 69.2 years with a standard deviation of 7.8 years. Majority of the elderly population were illiterate (70.1%). Higher proportion of females was illiterate (92.4%) as compared to males (49.5%). Among the 411 elderly persons, 188 (45.7%) sought treatment from private practitioner and private hospital, 133 (32.3%) from non registered practitioner (Quack), only 77 (18.9%) sought treatment from Government hospital and remaining 13 (3.1%) used home remedies or sought help from traditional healers. Conclusion: Majority of the geriatric subjects were in the age group of 60 to 69 years. Awareness must be generated among the elderly regarding the problems related to the ageing, strict implementation of legislation on parents’ care by their children and Promotion of income.
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The main objective of the study has been to identify trajectories of health seeking behaviour of the urban poor, particularly their use of the private health sector, with the aim to identify strategies to improve quality of health care for this burgeoning population. This article presents findings from a slum settlement in Delhi where ethnographic sub-studies were carried out over two years among private health providers and selected households alongside a survey of household expenditure patterns. The primary research tools were in-depth interviews with practitioners and key informants as well as observations of clinical interactions. Illness narratives and case studies were documented over two years. The software package q.s.r. Nvivo was used for coding and content analysis. It was found that almost 90% of the respondents exclusively depend on local unlicensed and unregistered practitioners for basic primary health care. Long distances, time-consuming procedures, rude behaviour and, in many cases, bribes that had to be paid to staff in the hospitals were cited as major deterrents to utilising government facilities. Despite the public health consequences of inappropriate treatment protocols and misuse of drugs by these untrained private providers, in the absence of a structured urban primary health care system in the country, they seem to be the only alternative for the burgeoning urban poor in vast metros such as Delhi.
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A cross-sectional, community based study was undertaken in Patpur slum of Bankura to determine the prevalence of chest symptomatics, their health care seeking Behavior and its correlates. Prevalence of chest symptomatics (cough for 3 weeks or more) was found to be 5.5%, three fourths of whom sought relief from a health care provider. Among them, 70.8% did so within 2 weeks, median being 7 days. No preference for either government or private health care provider was seen in first visit, where the major reason for choosing facilities was advice by family & friends (43.8%). Most of the chest symptomatics (75%) were retained in the same facility. Shift from private to government facility for subsequent visits (33.3%) was higher than from government to private facility (16.7%). The main reason (50%) for changing health facility was expectation for better service.
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In high- and low-performing districts of Bangladesh, the study explored the demand-side of maternal healthcare by looking at differences in perceived knowledge and care-seeking behaviours of women in relation to postpartum haemorrhage or eclampsia. Haemorrhage and eclampsia are two major causes of maternal mortality in Bangladesh. The study was conducted during July 2006–December 2007. Both postpartum bleeding and eclampsia were recognized by women of different age-groups as severe and life-threatening obstetric complications. However, a gap existed between perception and actual care-seeking behaviours which could contribute to the high rate of maternal deaths associated with these conditions. There were differences in care-seeking practices among women in the two different areas of Bangladesh, which may reflect sociocultural differences, disparities in economic and educational opportunities, and a discrimination in the availability of care.
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Objective To understand the infection sources, care seeking behaviour and STD prevention in STD clinic patients. Methods Four hundred and seventy four patients of 3 STD clinics in Shanghai were investigated with questionaires and interviewed. Results 94.1% respondents contracted STDs via sexual contact. 70.3% married females attributed their infection source to their husbands, while more than 80% males and unmarried patients were infected through casual or commercial sex partners. High risk populations were observed among salesclerks, hotel attendants, private businessmen and unemployed, who were liable to contract STD through extramarital sexual contact and had a low rate of condom use. 74.5% of patients who visited the clinics after their symptoms had appeared. 82.7%, 62.2%, 57.1% and 30.0% of patients, whose sex partners were their spouses, lovers, commercial sex workers and casual partners, respectively, promised to encourage their partners for STD check up. Although the care seeking behaviour among females was slightly more active than that among males, postponed treatment seeking behaviour, low rate of simultaneous treatment of both male and female partners and low rate of condom use were observed among total patients. Majority of patients practised unprotected sexual intercourse, 4.2% used condom in commercial sexual activities, only 9.7% used condom even after having contracted the present STDs. Conclusion It is implied that counselling and health education must be strengthened in STD clinics, aiming at improving the awareness of STD prevention, insistently and correctly using condom, carefully choosing sex partners and reducing the number of sex partners, and encouraging the patients to adopt healthier life style.