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Background and Objective: Health care industry is going through a renaissance with the advances in mobile Internet technology. Health care seeking has become easier for people and there are multiple providers offering online consultations and counselling. Sexual medicine is still an unrecognized specialty in India. People suffering from sexual health problems and dysfunctions have a lot of stigma approaching health care professionals. With the coming in of Internet-based services, people are finding it easier to seek help online anonymously. As an industry this is likely to continue to grow and offer opportunities to people in distress to seek help. Methodology: In the present study, we have done a retrospective analysis of 500 queries that were posted privately to the principal author. Results focused on the demographic details, the nature of the problem and an analysis of the content of the queries. The study discusses how the findings may be used to better understand the perceptions, concerns, and stated needs of people accessing online portals for sexual problems. This should also help equip counsellors interested in this field. Results: The study clearly brought out the gender differences among those accessing online health care portals for sexual issues. A majority of the queries were from men asking about issues related to size and curvature of penis, masturbation, premature ejaculation, erectile dysfunction. Many of these queries stemmed from the lack of correct scientific knowledge which led to health anxieties including frustration, depression, and low self-esteem.

Background: Information on the existing morbidity patterns and health care seeking behavior (HCSB) is essential for the analysis of most health related policy issues and enable governments to provide a need-based health care especially to rural communities. Methods: A community based cross sectional study was conducted from September 1st, 2015 to December1st, 2015 in Mahsama village, Ismailia Governorate, Egypt to determine acute morbidity patterns and HCSB of 839 households. Data were acquired on predesigned and pretested questionnaire. The household heads were considered as the respondents. The questionnaire included information on household incidence of acute illnesses during the preceding 4 weeks and related HCSB. Results: 839 home interviews were conducted with household heads to assess their HCSB and morbidity profile of their family members within the preceding 4 weeks of the study. 442 of respondents (52.7%) reported 984 recent acute illnesses in their families. Upper Respiratory Tract Infection (URTI) presented the most common disease (71.64%). Most patients (53.55%) consulted non-qualified providers. While 46.45% of patients preferred to consult qualified practitioners. The low cost (26.37%) and effectiveness of care (21.82%) were the main reasons behind the selection of the non-qualified providers. Respondents’ education level, family income and perception of disease severity were also found to be the main determinants of this pattern of HCSB.Conclusion: it is important to develop a need based health care delivery system and actions focusing on the morbidity patterns and beliefs of local community to direct their HCSB to qualified providers.

Background: Optimum utilization of primary health care system by older people is a challenge for every low and middle income country. Little is known about self reported health problems, health care seeking behaviour and cost coping mechanism of older people in developing countries. Objectives: This study aimed to measure self-reported health problems, health care seeking behaviour and expenditure coping mechanism of older people, and to describe its implication for primary health care delivery in rural Bangladesh. Methodology: It was a cross sectional study. In total, 362 older people were enrolled who sought health care preceding the last month of the interview. Descriptive and bivariate data analysis along with proportion test (z test) was carried out. Results: The most frequent self-reported health problems were fever (43.8%) followed by physical pain (15.2%). More than half of the respondents (57.5%) had a second health problem. Only one third (33.8%) visited qualified health providers having minimum western health or medical training from government approved authority. More than half (54%) of the older people spent for health care out of pocket from their own. Only 2% older people sold their assets or took loans to meet their health care. 36% older people thought that they could afford to pay for health care in future. Conclusions: The findings of this study will help in developing primary health care policy for older people in rural Bangladesh and similar settings in South Asia.

Background: Gynecological problems and health care-seeking behavior of postmenopausal women vary among populations and societies. Few data are available about times and types of gynecological problems of postmenopausal women and health care-seeking behavior, socio-demographic and reproductive factors among rural women of Bangladesh.Objectives: The present study was conducted to find out the prevalence of gynecological problems, to identify socio-demographic factors and to identify the health care seeking-behavior of rural postmenopausal women.Materials and Methods: This cross-sectional study was conducted in women aged 50−70 years. A purposive sampling technique was used to retrieve data from 252 postmenopausal women from 3 villages of Savar Upazilla of Dhaka, Bangladesh.Results: The mean age of our study population was 57.27 ± 6.08 years, and the mean menopausal age was 48.20 ± 3.226 years. Regarding prevalence of gynecological problems, 28% had vaginal dryness, 5% had per vaginal bleeding, 9% had urinary problems, and 4% had something coming down per vagina. For primary treatment, 43% went to pharmacy, 29% went to private chamber or private clinic, and only 22% went to government hospitals for their general health problems. Some significant association was found between age of marriage, number of fertility and gynecological problems.Conclusion: Further studies are needed with a larger sample size to identify different life style, diet, and socio-cultural characteristics and to better understand the health care-seeking behavior of women of rural communities.J Enam Med Col 2018; 8(3): 135-138

This study examined whether positive facial expressions in student identification photographs were connected with a health-relevant behavior: visits to a health care center in the last year for preventive and non-preventive (e.g. illness, injury) purposes. Identification photographs were coded for degree of smile. Smiling participants were more likely to have sought preventive care versus those not smiling in their photographs, but there was no difference in non-preventive (i.e. ill health) visits. This study shows for the first time that smiling in photographs may be related to healthy behavior and complements past work connecting smiling to positive psychosocial and health outcomes.

Patients are increasingly choosing health-care institutions based on online comments; thus, we examined the influence of different forms of word-of-mouth (electronic or traditional) on patients' health-care-seeking behavior. Data were collected from 415 patients who during 2015–2016 sought medical advice at a large 3rd-grade, class-A hospital in China. Results showed that, compared to those influenced by traditional word-of-mouth, patients influenced by electronic word-of-mouth paid significantly more attention to reviews of the health-care institutions, and also spent more time and energy choosing an appropriate health-care institution. In addition, treatment method (invasive vs. noninvasive) had a moderating influence on patients' confidence in the health-care institution. That is, those influenced by traditional word-of-mouth had greater confidence than those influenced by electronic word-of-mouth in invasive procedures provided by the chosen health-care institution, although there was no difference in confidence for patients undergoing noninvasive procedures. Practical and theoretical implications are discussed.

Purpose Male urinary incontinence (UI) is a global health issue associated with bothersome symptoms which affect daily life. This study aims to evaluate the prevalence of male UI in China, Taiwan, and South Korea and to determine if UI is an independent risk factor affecting the health-related quality of life (HRQoL), mental health, work limitations, and healthcare seeking behavior. Materials and Methods A post-hoc analysis was conducted on the LUTS Asia database which was collated from a cross-sectional, population-based internet survey in China, Taiwan, and South Korea. Prevalence of male UI was assessed, and the effect on HRQoL, Hospital Anxiety and Depression Scale (HADS) depression and anxiety scores, work performance, and healthcare seeking behaviors was determined using univariate and multivariate analyses. Results A total of 4,076 male participants were surveyed. Prevalence of male UI was 17.3%. UI adversely affected the HRQoL in both physical and mental domains. Both multivariate and univariate analyses showed that male UI could be correlated with a negative effect on the HADS anxiety and depression scores. Multivariate analysis suggested that work difficulties were correlated to the presence of UI. Up to 28% of participants who reported urge UI only did not adopt any management measures. Conclusions UI is common in men over 40 years and adversely impacts HRQoL. It is an independent risk factor for anxiety and depression and may cause significant work limitations. Despite these negative effects, many men still do not seek any intervention., Graphical Abstract

Background Delays in accessing effective health care plays a pivotal role in increasing Tuberculosis (TB) transmission within the community. Patna, North India, with high levels of poverty and weak public health system, faces huge challenges for achieving effective TB control. The study aims to determine delays that occur from onset of TB symptoms until initiation of pulmonary TB (PTB) treatment among patients in Patna. Methods Of the 109 self-reporting TB patients identified through an active household survey, 64 PTB patients were interviewed. First care seeking, TB diagnostic and treatment initiation durations were calculated and delays defined for new and retreatment patients and minors and adults. Outliers exhibiting extreme delays were additionally identified. Results A cross sMean total pathway duration for TB care was 40 days, with diagnostic duration contributing to 58% of the duration. No significant differences were noted between new and retreatment patients. Minors, comprising of 30% of total PTB patients accessed care faster than adults, but showed significantly higher diagnostic duration (38 days vs. 17 days). Preference for private sector, chemists and allopaths was seen throughout the pathway. Discussion Patna requires a more effective harnessing of the private sector augmented with reliable diagnostic investigations and a focus on quality.

Health care seeking behaviour is any action undertaken by individuals who perceive to have a health problem or to be ill for finding an appropriate remedy. It involves recognition of symptoms, perceived nature of illness, followed initially by appropriate home care and monitoring. In Ethiopia, little is known about mother’s health care seeking behaviour on neonatal danger signs. Therefore, this study assessed the health care seeking behaviour on neonatal danger signs among mothers in Tenta district, Northeast Ethiopia. Community based cross-sectional study was conducted from October 23 to November 17, 2015. The study district was stratified into urban and rural kebeles. From each stratum, 1 out of 3 urban and 7 out of 25 rural kebeles were selected by simple random sampling technique. A total of 527 mothers were interviewed using structured and pre-tested questionnaire. The data were checked for missing values and outliers, and analysed using SPSS version 20.0. Logistic regression analyses were employed to see the association between dependent and independent variables. Mothers who sought medical care for neonatal danger signs were 167 (41.3%). Mothers’ secondary educational level (AOR=4.64, 95% CI=1.1-19.81), have given birth in health center (AOR=3.35, 95% CI=1.31-8.56), practicing optimal thermal care (AOR=2.52, 95% CI=1.08-5.85), and having higher decision-making abilities in seeking neonatal health care (AOR=11.28, 95% CI=4.36-29.22) were significant predictors of mother’s health seeking behaviour towards neonatal danger signs. Long distance of the residence from health facility, experiencing less serious neonatal danger signs, and beliefs that some danger signs were caused by evil spirits were the most common reasons cited by mothers who did not seek neonatal medical care. In this study, more than half of mother’s did not seek medical care for neonatal danger signs. Maternal education and improving their decision-making abilities, and promoting institutional delivery are the recommended interventions to improve mother’s health care seeking for neonatal illness. Health facilities should integrate essential neonatal care service during ANC and PNC follow up to improve the quality of health information about neonatal danger signs. At the community level, health extension workers should educate mothers about newborn care practices and neonatal danger signs. Key words: Mothers’ health care seeking behaviour, neonatal danger signs, Tenta district.

Maternal health care seeking behavior (HSB) is a vital determinant of the overall maternal and child health of a country. The present study, which focused on women's autonomy as an important factor in the care-seeking behavior of women, is based on data from BDHS 2014, a nationally representative survey in Bangladesh. A total of 17,863 ever-married women (age 15 years and older) were enrolled in the study. Results showed that, after we controlled for all other predictive variables, higher autonomy status of women remained significantly associated with HSB (OR 1.31, CI 1.025, 1.674). Eliminating disparities in social class and stigma and challenging traditional and religious beliefs through mass media may help to alleviate the unmet health seeking.

Purpose Numerous studies have investigated the prevalence of constipation and fecal incontinence (FI) in the general population and, even though these disorders are known to co-occur, they were studied independently of each other. Our aim was to investigate the prevalence of constipation and FI, and their co-occurrence, in the general population in the Netherlands. Methods We studied a cross-section of the Dutch population (N = 1259). All respondents completed the Groningen Defecation & Fecal Continence checklist. We defined constipation and FI in accordance with the Rome III criteria. Results We found that 24.5% (95% CI, 22.1–26.8) suffered from constipation, 7.9% (95% CI, 6.4–9.4) suffered from FI, and 3.5% (95% CI, 2.5–4.5) suffered from both disorders. Constipated respondents were 2.7 times more likely to suffer from FI than non-constipated respondents (95% CI, 1.8–4.0). Moreover, 48.7% of the respondents with constipation, 35.0% with FI, and 38.6% in whom the disorders co-occurred qualified their bowel habits as either “good” or “very good”. We found that 49.4% of the respondents with constipation and 48.0% with FI had not discussed their complaints with anyone. Conclusions Constipation and FI, isolated or co-occurring, are common disorders in the general population, even in young and healthy respondents. Since constipation and FI often co-occur, we recommend that patients who seek medical attention for either disorder should be examined for both. Moreover, constipation and/or FI are not always identified appropriately by patients. Therefore, physicians should take the initiative to diagnose and treat these disorders. Electronic supplementary material The online version of this article (doi:10.1007/s00384-016-2722-3) contains supplementary material, which is available to authorized users.

Background Flu Near You (FNY) is an online participatory syndromic surveillance system that collects health-related information. In this article, we summarized the healthcare-seeking behavior of FNY participants who reported influenza-like illness (ILI) symptoms. Methods We applied inverse probability weighting to calculate age-adjusted estimates of the percentage of FNY participants in the United States who sought health care for ILI symptoms during the 2015–2016 through 2018–2019 influenza season and compared seasonal trends across different demographic and regional subgroups, including age group, sex, census region, and place of care using adjusted χ 2 tests. Results The overall age-adjusted percentage of FNY participants who sought healthcare for ILI symptoms varied by season and ranged from 22.8% to 35.6%. Across all seasons, healthcare seeking was highest for the Conclusions The percentage of FNY participants who sought healthcare for ILI symptoms varied by season, geographical region, age group, and sex. FNY compliments existing surveillance systems and informs estimates of influenza-associated illness by adding important real-time insights into healthcare-seeking behavior.

Background People with multiple sclerosis (MS) require complex care throughout life. Canadians with MS are high users of health-care services, yet still report unmet health-care needs and low satisfaction with services received. Objective This study aimed to investigate the health-care access experiences of Ontarians with MS as they manage their condition. Design and participants Interpretive description guided data collection and analysis. Forty-eight people living across seven communities participated. Thirty-eight participated in one of five focus groups; the remaining 10 participated in an individual semi-structured interview. Results Participants described the experience of accessing care as a decisional process, guided by a form of cost-benefit analysis. The process determined whether seeking conventional health-care services 'is worth it'. Most participants felt that the energy and resources required to access the health-care system outweighed their expected outcomes, based on past experiences. Participants who did not see the benefit of care seeking turned to self-treatment, use of complementary and alternative services, and engaged in patterns of health-care avoidance until a crisis arose. Discussion and conclusion Findings suggest that a renewed effort to promote patient-centred care and a biopsychosocial approach may improve the health-care access experiences of persons with MS and reduce service avoidance.

With an overview of the health service sector of Bangladesh, this study focuses on health service trade in Bangladesh and possible regional cooperation to enhance health service trading in the South Asian Association for Regional Cooperation (SAARC) region. Health Care seeking behaviour of the Bangladeshi patients are examined using Mean Score of Relative Importance (MSRI) analysis. Health service trade in Bangladesh under four modes are also examined. This study also addressed the prospects and challenges associated with health service trade.

The continent of the Americas has the greatest number of people infected and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the world. Brazil occupies the 2nd position in numbers of infected cases and deaths, preceded only by the United States. Older adults and those with pre-existing chronic illnesses are more vulnerable to the consequences of the virus. The SARS-CoV-2 epidemic has serious consequences for health services. Therefore, an assessment of the pandemic’s effect on the older Brazilian population is urgently needed. The study examines the prevalence of COVID-19 related symptoms, care-seeking, and cancellation of surgery or other scheduled medical care among a nationally representative sample of Brazilians aged 50 and over derived from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and a telephone follow-up survey (the ELSI-COVID-19 initiative) between late May and early June 2020. About 10.4% of older adults reported any fever, dry cough or difficulty breathing in the 30 days prior to the interview, with the highest prevalence in the North region (50%). Among individuals with symptoms, only 33.6% sought care. Individuals living in the South or Southeast regions were significantly less likely to seek care for COVID-19 related symptoms. Nearly one in six participants had to cancel scheduled surgery or other medical care; this proportion was higher among women, those with more education, and people with multiple chronic conditions. This paper is among the first to investigate the effect of COVID-19 on health care use in Brazil among older adults. Results highlight the need to adapt health care delivery (such as through telemedicine) to ensure the continuity of care as well as the urgent need for wide dissemination of information to guide the population on disease prevention measures and how to obtain healthcare when needed.

Introduction: Objective of this study is to determine the knowledge, attitude and practice regarding type 2 diabetes in diabetics as well as in Non-diabetics and also to determine the knowledge versus practice gap among diabetics. There is almost no study of this kind from Uttar Pradesh region of India. Material and method: A pretested and validated questionnaire were used for assessment of these parameters. This questionnaire was divided in to 3 parts. First part used for assessment of knowledge in all the study subjects and had 8 questions. Second part had five questions based on risk factors and complication of diabetes. Third part was used only for diabetics and again had five questions based on their health care seeking behavior. A total of 412 study subjects (206 diabetics and 206 Non-diabetics) were interviewed and their responses were noted in this questionnaire form. Results: 50% of the diabetics are in the age group category of 41-60 years. > 50% of non-diabetics are in the age group category 21-40 years. Most of the respondents were aware of symptomatology, non-communicability, need of self-monitoring of glucose at home and rapidly increasing incidence of diabetes. Almost 70 % of diabetics were aware about foot care and Very nominal number of diabetics (7.8%) was consuming sweets daily. A disheartening fact revealed that approximately 87% of diabetics do not carry sugar candy or any form of sugar before leaving home to correct any hypoglycemic episode. Conclusion: Knowledge of symptomatology of diabetes and requirement of self-monitoring of blood glucose at home was adequate among most of the study subjects and uniformly distributed among diabetics and Nondiabetics. More than 80% of diabetics were not aware about hypoglycemia symptoms and its treatment. Training of health care providers and large-scale education and awareness campaigns are the need of the hour for this region to further improve the knowledge and to improve self-care practices among all Diabetics.

Given the targeted 4–5% annual reduction of tuberculosis (TB) cure cases to reach the “End TB Strategy” by 2020 milestone globally set by WHO, exploration of TB health seeking behavior is warranted for insightful understanding. This qualitative study aims to provide an account of the social, cultural, and socioeconomic breadth of TB cases in Bangladesh. We carried out a total of 32 In-depth Interviews (IDIs) and 16 Key Informant Interviews (KIIs) in both rural and urban areas of Bangladesh. We covered both BRAC [a multinational Non-governmental Organization (NGO)] and non-BRAC (other NGOs) TB program coverage areas to get an insight. We used purposive sampling strategy and initially followed “snowball sampling technique” to identify TB patients. Neuman’s three-phase coding system was adopted to analyze the qualitative data. Underestimation of TB knowledge and lack of awareness among the TB patients along with the opinions from their family members played key roles on their TB health seeking behavior. Quick decision on the treatment issue was observed once the diagnosis was confirmed; however, difficulties were in accepting the diseases. Nevertheless, individual beliefs, intrinsic ideologies, financial abilities, and cultural and social beliefs on TB were closely inter-connected with the “social perception” of TB that eventually influenced the care seeking pathways of TB patients in various ways. Individual and community level public health interventions could increase early diagnosis; therefore, reduce recurrent TB.

Background and objectives: Fever in children is one of the most common reasons for seeking medical attention. Parents often have misconceptions about the effects to fever, which leads to inappropriate use of medication and nonurgent visits to emergency departments (ED). The aim of this study was to clarify the beliefs on the effects and management of fever and to identify healthcare seeking patterns among parents of febrile children in Latvia. Materials and Methods: Parents and legal guardians of children attending ED with febrile illness were included in the study. Participants were recruited in Children&rsquo, s Clinical University Hospital (CCUH) in Riga, and in six regional hospitals in Latvia. Data on beliefs about fever, administration of antipyretics, healthcare-seeking behavior, and experience in communication with health care workers were collected via questionnaire. Results: In total, 355 participants were enrolled: 199 in CCUH and 156 in regional hospitals, 59.2% of participants considered fever itself as indicative of serious illness and 92.8% believed it could raise the child&rsquo, s body temperature up to a dangerous level. Antipyretics were usually administered at median temperature of 38.0 &deg, C, and the median temperature believed to be dangerous was 39.7 &deg, C, 56.7% of parents usually contacted a doctor within the first 24 h of the illness. Parents who believed that lower temperatures are dangerous to a child were more likely to contact a doctor earlier and out-of-hours, 60.1% of participants had contacted their family doctor prior their visit to ED. Parental evaluation of satisfaction with the information and reassurance provided by the doctors at the hospital was higher than of that provided by their family doctor, 68.2% of participants felt safer when their febrile children were treated at the hospital. Conclusions: Fever itself was regarded as indicative of serious illness and potentially dangerous to the child&rsquo, s life. These misconceptions lead to inappropriate administration of antipyretics and early-seeking of medical attention, even out-of-hours. Hospital environment was viewed as safer and more reassuring when dealing with febrile illness in children. More emphasis must be placed on parental education on proper management of fever, especially in primary care

IntroductionHealth care seeking interventions can reduce child mortality from easily treatable diseases, however, significant numbers of children die by diarrheal disease due to delays in seeking care in Ethiopia. Thus, the aim of this study was assessed health care seeking behavior and associated factors among mothers/caregivers of under-five children with acute diarrhea in Dangila zuria Woreda, North West Ethiopia, 2018.MethodCommunity-based cross-sectional study design was conducted using structured questionnaires. Data were entered Epi Data Version 3.1 and analyzed using SPSS Version 23. Descriptive statistics were used to examine patterns of health care seeking behavior and multivariable logistic regression analysis was applied to identify factors associated with health care seeking behaviorResultThe magnitude of health care seeking behavior of mothers/caregivers of under-five children with acute diarrhea was found to be 77.7%. Primary level of education [AOR = 2.0; 95% (CI (1.1-3.9)], sex of child (male) [AOR = 1.7; 95% (CI 1.1-2.6)], availability of health facilities within 60 minutes walking distance [AOR = 2.4; 95 %(CI 1.4-4.1)], severity of illness [AOR=7.5; 95% (CI 3.7-15.2)], two or more under-five children in the family [AOR=0.6;95% (CI 0.4-0.9)], perceived cause of acute diarrhea, (new teeth [AOR =0.3;95% (CI 0.2-0.5)] were significantly associated with health care seeking behavior of mothers/caregivers.ConclusionIncreasing the proximity of health facilities and educate mothers/caregivers about the importance of health care seeking behavior and cause of acute diarrhea were recommended to improve health care seeking behavior.

Background: Gender differences can be in any stage in the life cycle including before birth (feticide/sex selective abortions) which have been objectively documented. This study tries to identify the gender differentials among the children which is a basic step in cascade process of female discrimination in the society. Objective: To study the gender differentials among children under 6 years in households of rural Ballabgarh, Haryana in terms of nutrition, health care seeking, social aspects and to see whether they differ by socio economic status. Methods: Two hundred households were selected purposively from four villages (50 households each) by multi stage sampling during Mar – June 2010. Pre tested interview schedule was used to assess gender differences in nutrition (breast feeding, 'z' score); in health care seeking and in social aspects (Expenditure on birth related ceremonies and toys and dresses). Differences are measured in means or proportions. Determinants of Gender differentials were identified by logistic regression. Results: Girls were breast fed for five months lesser than boys (P < 0.02). Even though occurrences of common childhood illnesses were equal between the two, expenditures incurred to treat these illnesses were more among the boys (Boys Vs girls: Rs 181.3 Vs Rs 123.9). Proportion of illnesses treated from health facilities located outside the villages was higher among the boys [boys (22.2%), girls (11.4%)]. Expenditures incurred during birth related social ceremonies were higher for boys (Rs 20311 and Rs 2487.5 respectively for boys and girls). Conclusion: In this patriarchal society, socio cultural norms have produced the gender gap which can have adverse impact on health of the female children.

Background In Turkey, a mandatory referral system is not used. Caregivers, for their children, present directly to health-care providers at all levels. This allows patients to present directly to university hospitals. In this study, reasons for university hospital-treatment seeking by caregivers for child health problems is discussed. Methods This was a cross-sectional descriptive study at Dokuz Eylul University Faculty of Medicine, Izmir, Turkey, of 235 caregivers whose children were admitted to the outpatient clinic of the General Pediatrics Department between 4 and 11 April 2013. They completed a questionnaire on demographic data and reasons for presentation to the university hospital. Mann–Whitney U-test was used to compare group means, and Pearson chi-squared test for ratios between groups. P

The world has been unable to meet the United Nations Millennium Development Goals (MDGs) of reducing child mortality by 2015. Since 1990, there is an established disparity of under-5 mortality rates among countries across the globe. This disparity is due to high burden of child deaths in several of the low income countries. These high burden countries includes India, Nigeria, Pakistan and Democratic Republic of the Congo (DRoC) (UNICEF-Report-2015). Currently, these four countries carry almost 45% of the global burden of child deaths. If these high burden countries continues to shows such trends of child mortality, then in the next 15 years or so, they will be carrying almost half of the global burden of child mortality (UNIGCME-2015). Link:http://aeirc-edu.com/ojs14/index.php/IJEHSR/article/view/120/337

The aim of this study was to estimate the prevalence and incidence of hypertension in women, and describe their self-care and health-seeking behaviours. This research was conducted as part of the Australian Longitudinal Study on Women's Health, a study comprising a nationally representative sample of Australian women in three age groups. The focus of this research is 14 099 women born in 1946-1951, who have been surveyed six times (1996-2010). Student t-tests were used to compare women who did or did not have hypertension by their health-care utilization. Longitudinal analyses were conducted using a Poisson generalized estimating equation model. The incidence of hypertension among this cohort during 1996 to 2010 ranged from 400 to 597 participants per survey, resulting in an increase in prevalence of hypertension from 20.9% in 1996 to 41.3% in 2010. For all survey periods, women with hypertension had a significantly higher average number of visits to doctors and allied health practitioners compared with women without hypertension (P0.005). The use of complementary medicine (practitioners and self-prescribed treatments) by women with hypertension was significantly lower compared to women without hypertension (P0.005). Over time, conventional health-care utilization was higher for women with hypertension compared with women without hypertension (adjusted RR=1.18; 95% CI: 1.14, 1.22; P0.0001). Our findings show that women with hypertension are using a range of conventional and complementary and alternative medicine: with hypertensive women using more conventional medicine and less complementary and alternative medicine than non-hypertensive women. As such, health-care providers should communicate with their patients regarding their use of complementary and alternative medicine in their efforts to provide safe, effective and coordinate care.

Background People who inject drugs (PWID) suffer from a high burden of infectious disease. At the same time, they often have poor access to health care. As in other East African countries, the population of PWID is growing in Tanzania, but little is known about their contact with health care services. In this paper we examine patterns of health care use among PWID in Dar es Salaam and identify what factors are associated with regular contact with clinicians during illness. Methods We conducted a baseline cross-sectional study as part of a prospective cohort study involving PWID. We recruited 578 PWID, of whom 273 were newly enrolled on an integrated methadone-assisted treatment (MAT) program and 305 were community-recruited. At baseline, we interviewed the MAT program enrollees before they received services at the program clinics. We used bivariate and multiple logistic regression analyses to identify the factors associated with seeking medical care when ill. Results Only 25.4% of 578 participants reported seeing clinicians regularly when they needed medical care. Participants were more likely to see clinicians regularly if they were employed, (OR: 2.25, 95% CI: 1.28–3.98), had higher income levels (OR: 1.10, 95% CI: 1.00–1.22), were parents (OR: 1.71, 95% CI: 1.09–2.68), or knew where to seek affordable care (OR: 3.42, 95% CI: 2.12–5.52). Conclusion PWID in Dar es Salaam generally did not seek health care when needed. To improve their health care seeking behaviour, it is important to advise PWID about where to seek affordable health care and to increase their income-generating skills.

Patients’ delay in seeking health care is a major problem in the control of tuberculosis (TB) and increases the risk of TB transmission. This study determined health-seeking practices and delays that occurred from the onset of TB symptoms until diagnosis and assessed the patients’ TB-related knowledge. This was a cross-sectional study involving 391 new TB patients recruited from health facilities at an urban sub-district in South Africa from December 2016 to March 2017. Descriptive statistics and logistic regression analyses were performed using Stata 14. Over half (56.3%) of the patients delayed seeking health care for more than 30 days after the onset of their symptoms, 32% sought treatment from informal providers, and 13.3% self-medicated. Lack of suspicion of a TB diagnosis, which was prevalent in 45% of respondents, was statistically associated with delay in seeking healthcare (AOR = 0.53, CI: 0.32-1.87). Overall TB knowledge was high, correct knowledge about TB transmission was 92.6%. TB knowledge was significantly associated with educational status (AOR = 3.96, CI: 1.69-9.28) and seeking treatment from informal sectors (AOR = 0.17, CI: 0.03-0.95). High overall TB knowledge was not statistically associated with seeking health care for TB diagnosis and treatment. We found a substantial delay between the onset of TB symptoms and seeking healthcare from a public health facility providing TB screening services. Promoting early screening and diagnosis through increasing awareness of TB is key in the elimination of TB in communities with a high TB burden

Irritable bowel syndrome (IBS) is one of the most common diagnoses made by healthcare providers. Yet the majority of patients with IBS are undiagnosed. The study by Sayuk et al. allows insight into the characteristics of different patient groups, e.g., with and without a formal diagnosis of diarrhea predominant IBS (IBS-D). We discuss the questions raised by this study regarding the importance of making a confident diagnosis, conveying it to patients and their implications for clinical practice.