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This article presents data on family caregiving for elders with dementia in Oaxaca, Mexico. Drawing on a year of ethnographic research, this article explores how caregivers engage in health-seeking behaviors and how they choose between biomedical and traditional medical alternatives. While caregivers are primarily concerned to maintain elders' health, decisions about which medical providers to (not) consult invoke broader social factors that go beyond their relationships with elders, and concern socioeconomic realms of power, as well as broader ideals concerning local tradition and its maintenance in the contemporary world. [ABSTRACT FROM AUTHOR]

In a setting where substance use is rife, understanding contextual factors that influence an individual's perceived eligibility to seek rehabilitation is paramount. The study explores how situational factors influence an individual's perceived eligibility for healthcare uptake in people with substance use disorder (SUD). Using qualitative methods, the study draws on in-depth interviews with 20 substance users and 20 family members to unpack how individuals with SUD negotiate their eligibility for health services. Findings show that substance users are aware of their substance use habits and acknowledge their eligibility for health services with information on the navigation of health services is shared by peers and family members. Access and use of health services is hindered by individual determinants and the availability of health services for substance users, such as rehabilitation centers. The hunt for drugs and long waiting queues for health service acquisition overshadows substance users' claim to health services. Future research should prioritize understanding substance use and health seeking behavior at a context specific level in community settings so that, even in the absence of substance use health facilities, substance use is addressed at least from a harm reduction perspective which can improve health outcomes. [ABSTRACT FROM AUTHOR]

The present research aimed to investigate the correlation between health-seeking behavior, e-health literacy, and successful aging variables. The study population consisted of individuals aged 65 and over in Samsun province of Turkey. The study data were collected by the survey method between November 1–30, 2022, and the data obtained from 773 people were evaluated with various statistical methods. The regression analysis determined that health-seeking behavior explained 20.1% of the total variance on successful aging, e-health literacy explained 28.3% of the total variance on successful aging, and e-health literacy explained 34.6% of the total variance on health-seeking behavior. [ABSTRACT FROM AUTHOR]

Background: Undiagnosed hypertension is a major public health problem causing severe cardiovascular disorders that are responsible for a high proportion of morbidities and mortalities, especially among adults living in low-income countries. However, there is a paucity of information that describes its epidemiology in Ethiopia. This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among adults in Durame town, southern Ethiopia. Methods: A community-based cross-sectional study was conducted from July to September 2022. Data were collected from 526 randomly selected adults aged =18 years using a pre-tested questionnaire. The binary logistic regression models were used to identify factors associated with undiagnosed hypertension. Results: The prevalence of undiagnosed hypertension among adults in Durame town, southern Ethiopia, was found to be 14.0% (95% CI: 11.2-17.1). Family history of hypertension [AOR = 6.9, 95% CI: (3.62, 13.27)], drinking too much alcohol [AOR = 5.7, 95% CI: (2.97, 10.75)], physical inactivity [AOR = 2.5, 95% CI: (1.34, 4.73)], consuming street foods regularly [AOR = 2.8, 95% CI: (1.28, 6.01)], and seeking healthcare for hypertensive symptoms without serious illness [AOR = 2.4, 95% CI: (1.28, 4.56)] were significantly associated with developing undiagnosed hypertension. Conclusion: The study has revealed that one in seven adults had undiagnosed hypertension in the study area. Thus, interventions to prevent hypertension should target increasing awareness among people with a family history of hypertension, controlling excessive alcohol consumption, promoting physical exercise, regulating street food markets, and improving the health-seeking behavior of adults in urban settings. [ABSTRACT FROM AUTHOR]

Background: The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active. Methods: Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis. Results: Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) 'unpredictable' troubles: they tended to favor the 'optimal' solution of keeping their lives in order rather than the best medical treatment options. Conclusion: This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the 'inaccessibility' of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education. [ABSTRACT FROM AUTHOR]

Objective: This study was identified seeking treatment for hypertension and diabetes among male shift workers. Method: This retrospective cohort study included nine large companies in Japan. Data were collected from health checkup, health insurance records, and self-administered questionnaires in 2017 and 2020. Data were analyzed using Kaplan-Meier curves and Cox regression. Result: Person-days shift workers and day workers seeking treatment for hypertension were 41,604 and 327,301, respectively and, for diabetes, were 7326 and 60,735, respectively. The log ranks were statistically significant. Shift workers were 46% and 56% less likely to seek treatment for hypertension and diabetes, respectively, than day workers were after adjustment for age, marital status, education level, and intention to modify lifestyle (model 2) ( P < 0.01). Conclusions: Male shift workers are less likely to seek treatment for hypertension and diabetes compared with day workers. [ABSTRACT FROM AUTHOR]

Introduction: Social and economic position, environment, access to healthcare, ethos, and worldview are all important determinants of people's health-seeking behavior. Tribal communities in India oscillate between their emic rationale for the cause and treatment of health concerns on the one hand and affordable modern methods on the other. The present article is based on a study conducted among the Junag tribe of Odisha to understand their acceptance and preference for traditional or modern healthcare systems and the reasons for these choices. Material and Methods: Purposive sampling, a pre-structured schedule, an observation approach, case studies, and interviews with community members have been used to gather the primary data used in the study. Result: The study identified a diverse pattern of health-seeking behavior. From the four villages, 70% of respondents combined into cluster-1 preferred the traditional healthcare system, mostly for geographical and cultural reasons, as opposed to 95% of respondents from the villages in cluster-2, who preferred modern healthcare services because they were more easily accessible and involved modern healthcare providers. Conclusion: In this research work, it has been found that the Juang tribe is in a transitional phase and uses a hybrid approach to health seeking. Moreover, it has also been discovered that important variables including cultural attitudes and the affordability of contemporary healthcare services have influenced people's decisions toward healthcare systems. [ABSTRACT FROM AUTHOR]

Background: Health-seeking behavior during pregnancy significantly influences maternal and neonatal outcomes, particularly in high-risk cases. Our study aims to understand the health-seeking behavior of high-risk antenatal women in rural areas and identify factors influencing their choices. Methods: A cross-sectional study was conducted among 108 high-risk antenatal females in selected Primary Health Centers (PHCs) of Ahmednagar District, India. Data were collected through validated structured questionnaires assessing healthseeking behavior, ANC visit frequency, and knowledge of pregnancy complications. Results: The mean age of participants was 26.9 years, with the majority (47.2%) falling within the age group of 25 to 29 years. 90.7% of participants had <3 ANC visits, revealing suboptimal health-seeking behavior. During illness, 54.6% visited doctors, 25.0% used home remedies, 13.0% opted for over-the-counter medications, and 7.4% consulted spiritual healers. Only 19.4% were aware of pregnancy complications. Conclusion: The study highlights inadequate ANC attendance and diversified health-seeking behaviors among high-risk antenatal women in rural areas. The findings emphasize the need for tailored interventions targeting age-specific health education, improved ANC awareness, and culturally sensitive healthcare services. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to explore the health-seeking behaviors of athletes with limb deficiency, drawing on the experiences and perception of the sports medicine team and athletes. Design: The study used an interpretive hermeneutic phenomenological methodology with a subtle realist paradigmatic view to investigate commonality in unique experiences within reality. Data collection was completed with two focus groups in December 2019 and March 2020. Thirteen participants took part including athletes and sports medicine team members (physiotherapists, doctors, and strength and conditioning coaches) working in parasports. Focus group manuscripts were transcribed verbatim from audio recordings. An inductive, iterative process was used to identify themes and subthemes, with processes in place to establish rigor. Results: Two themes and five subthemes emerged in relation to the "internalization and adjustment to social identity" and "the importance and impact of factors, which impact the athlete social identity." Conclusions: Health-seeking behaviors of athletes with limb deficiency were influenced by a unique blend of personal and environmental factors that contribute toward social identity. The sports medicine team require specific awareness of factors that may diminish health-seeking behaviors to deliver a personalized approach and negate consequences. [ABSTRACT FROM AUTHOR]

Most individuals with orofacial cleft require various healthcare services, including speech therapy. However, Filipino patients constantly face challenges in availing these services due to limitations in the healthcare system of the Philippines. This study aimed to explore the perceptions of patients with orofacial cleft on the factors that may serve as facilitators and barriers to speech intervention. A descriptive phenomenological approach to qualitative research was used to obtain an in-depth understanding of the perceptions of these patients. Semistructured interviews were conducted through online video conferences or mobile phone calls. Twenty-one participants were interviewed, most of who were mothers (90%) of children with orofacial cleft. Ten themes were derived from the transcripts. Five were categorized as facilitators, while the rest were considered as barriers. Generally, the respondents showed positive attitudes toward orofacial cleft, were aware of the communication and swallowing issues of the patients, and actively sought services to address these issues. Most barriers to speech intervention resulted from limited access to quality healthcare services and information. These findings highlight the importance of considering patient perspectives in clinical care. Maximizing facilitators and addressing barriers may improve access to universal healthcare among Filipinos with orofacial cleft. [ABSTRACT FROM AUTHOR]

Background: The gender gap remains a major impediment in the path toward equality, and it is especially wide in low-income countries. Gender differences in health-seeking behaviors may be a factor. Family size and childbirth order are two critical factors affecting family resource allocation. This study examines gender differences in healthcare-seeking behaviors among children with visual impairment in rural China across different family structures (birth order and family size). Methods: We draw on a dataset containing 19,934 observations constructed by combining data from 252 different school-level surveys spanning two provinces. The surveys were all conducted in 2012 using uniform survey instruments and data collection protocols in randomly selected schools across western provinces in rural China. The sample children range in grades from 4 to 5. Our analysis compares rural girls with rural boys regarding vision health outcome and behavior (vision examination and correction). Results: The findings revealed that girls have worse vision than boys. Regarding vision health behaviors, girls have a lower overall vision examination rate than boys. There is no gender difference when the sample student is the only child or the youngest child in the family, but there is still a gender difference when the sample student is the oldest child in the family or the middle child in the birth order. When it comes to vision correction behavior, boys are more likely to own eyeglasses than girls are for groups of students with mild visual impairment, even when the sample student is the only child in the family. However, when the sample student has another brother or sister (the sample student is the youngest, the oldest child in the family, or the middle child in the birth order), the gender difference disappears. Conclusions: Gender differences in vision health outcomes are correlated with gender differences in vision health-seeking behaviors among rural children. Depending on the birth order and family size, gender disparities in visual health practices vary. In the future, consideration should be given to providing medical subsidies to reduce the cost of vision health behaviors and to provide information interventions to change gender inequality in households and promote equality in children's vision health behaviors. Trial registration: The trial was approved by the Stanford University Institutional Review Board (Protocol No. ISRCTN03252665). Permission was received from local Boards of Education in each region and the principals of all schools. The principles of the Declaration of Helsinki were followed throughout. Written informed consent was obtained from at least one parent for all child participants. [ABSTRACT FROM AUTHOR]

Study Design: Cross sectional. Introduction: In developing countries like Saudi Arabia, most of the newborn deaths are reported to take place at home. Majority of such deaths have been caused due to lack of awareness, late detection of symptoms of critical infection by caregivers and mothers, and late decision-making in seeking healthcare services. Mothers' familiarity on symptoms recognized by the WHO is very important for health-seeking behavior of mothers. Objective: This study is aimed to investigate the awareness, health-seeking behavior and knowledge of caregivers and mothers about neonatal danger signs in Saudi Arabia. Methodology: A "community-based, cross-sectional study" was conducted on awareness level of mothers in Saudi Arabia on neonatal danger signs suggested by WHO. The sample size consists of 4518 mothers who have delivered the baby over the past two years and nurtured a baby. A self-structured questionnaire was designed to share online to gather the data. The data was analyzed through IBM SPSS v20.0 to evaluate awareness and experience of mothers about danger signs with one-sample t-test with confidence interval of 95%. Results: In this study, 1265 (28%) participants recognized yellow palms/sores as a danger sign in newborn child. Additionally, 19.4% and 18.8% women recognized fast breathing and convulsion as danger signs, respectively. Child not feeding since birth or stopped feeding is another sign recognized by 7.7% participants, weakness or lethargy was recognized by 4% participants, excess crying was recognized by 3.8% participants and weight gain was recognized by 2.3% participants. After performing one sample t-test with confidence interval of 95%, it was observed that there is a significant impact of participants' familiarity on recognizing "neonatal danger signs (p<0.05)". [ABSTRACT FROM AUTHOR]

Background: Migration to Norway has increased rapidly in recent decades. Migrants have a lower prevalence of substance use, but may have an elevated risk of developing mental health issues and substance use problems due to various migration and post-migration factors. Few studies have sought to understand substance use problems among migrants in Norway. This study aimed to explore how people of East African background experience help-seeking for substance use problems in the Norwegian healthcare system. Methods: Using an explorative approach, in-depth individual interviews were conducted with six adult participants from Somalia, Eritrea and Sudan who had been in contact with the Norwegian healthcare system. The goal of the interviews was to facilitate in-depth and nuanced descriptions of the participants' lived experience of help-seeking for substance use problems. The data were analysed using interpretive phenomenological analysis. Results: The analysis resulted in five themes in which participants described their help-seeking experiences for substance use problems as lack of knowledge and access to information, scepticism towards a 'white system', fear of exclusion from family and ethnic community, racism as a barrier to help-seeking, and positive experiences and ideas for future treatment practices. Conclusion: This study provides an improved understanding of how migrants with substance use problems experience help-seeking in healthcare. The variety of barriers illustrates inequality in substance use care for East African migrants in Norway. [ABSTRACT FROM AUTHOR]

While employing a phenomenological perspective, the present study aimed to explore the varied experiences of transgender individuals in Kashmir, concerning their health-seeking behavior, and the constraints they face while accessing healthcare resources on a day-to-day basis in their life world. Participants were recruited through the purposive and snowball sampling strategies and the sufficiency of sample size was determined by data saturation. Data were collected using face-to-face in-depth interviews and analyzed through Colaizzi's procedure of extracting recurrent themes and their interwoven relationships in qualitative research. Three main themes of awareness and the preferences for healthcare, gender identity and persistent stigmatization in care settings, and intra-community support and the resultant caregiving were prominent. Results of the study revealed that the transgender individuals in Kashmir experience inappropriate health-seeking behaviour primarily due to their unawareness regarding health, diseases and public healthcare programs/schemes, financial constraints, social exclusion, improper support and social stigma. They often prefer treating their health issues, mostly through local pharmacies or patent medicine vendors (PMVs), instead of visiting the medical professionals in the organized sector. Moreover, in many instances, they were also found to delay their decisions to seek care or simply decided to remain far from any medical intervention. As a result, the transgender individuals in Kashmir usually experience underutilization of formal healthcare services, which undermines their right to proper health and well-being. [ABSTRACT FROM AUTHOR]

This study was carried out to determine the effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women. This study was conducted online between June and September 2021. Women aged 21–65 years were invited to participate in the study via social media. A total of 396 women comprised the sample for this study. Data were collected the Fear of COVID-19 Scale, and the Health-seeking Behavior Scale. Data were evaluated using descriptive statistics, parametric tests and regression analysis. As a result of the study, 11.1 percent of women were found to have had a Pap smear test during the pandemic period. Fear of COVID-19 was determined to have a positive and significant effect on online health-seeking behavior (t = 7.915, p <.001), professional health-seeking behavior (t = 4.503, p <.001), traditional health-seeking behavior (t = 6.037, p <.001), and general health-seeking behavior(t = 8.390, p <.001) while it did not have any effect on having a Pap smear test (p >.05). This study showed that although the fear of COVID-19 positively affected health-seeking behaviors in women, the rates of gynecological examination and Pap smear test rates were low during the pandemic. [ABSTRACT FROM AUTHOR]

Steady improvement in quality of life has led to increased survival time of elderly, especially of those with noncommunicable diseases. A study about their health-seeking behavior (HSB) and its determinants is essential for provision of comprehensive care and facilitate policy development. A cross-sectional study was conducted among 350 elderly participants over 60 years of age in an urbanized village of Delhi. Data was collected using a semi-structured questionnaire, and detailed general and systemic examination was done. Tests of significance were applied to assess the HSB with various demographic, clinico-social, and economic variables. A total of 87.4% of the study population was suffering from at least one noncommunicable disease (NCD). Majority of the study subjects' NCDs (72.66%) were diagnosed while getting treatment for a symptom of the disease. Also, 52.94% of the participants had inappropriate HSB. HSB was significantly associated with gender, age, duration of illness, and importantly with modifiable variables like the level of literacy, distance of preferred health facility, and presence of multimorbidity. HSB was found to be inappropriate in over half of the participants. Policymaking should focus on modifiable variables like education, distance of health facility, and multimorbidity, especially for commonly ignored diseases like osteoarthritis and diabetes. [ABSTRACT FROM AUTHOR]

Prehospital delay after stroke symptom onset is a primary barrier to eligibility for reperfusion therapies. Decision delay is an understudied contributor to prehospital delay. We aimed to explore decision delay as a component of prehospital delay. For this correlational study, 170 Thai acute stroke patients were interviewed to explore their treatment-seeking decision factors: prior stroke knowledge, onset context, and cognitive, emotional, and behavioral factors. Participants' mean age was 61.2 years, and 46% were women. Median decision delay and prehospital delay times were 120 and 372 minutes. Decision delay represented 49% of prehospital delays. Factors shortening decision delay were atrial fibrillation, prior stroke knowledge, perceived cause of symptoms as stroke, perceived severity of symptoms, and advice from bystanders to seek treatment. In contrast, seeking support from others and self-treatment affected prolonged decision delay. Shortening decision delay, often under the patient or bystander control, can reduce overall prehospital delay. [ABSTRACT FROM AUTHOR]

We conducted a community-based cross-sectional survey of 416 participants from Meghalaya, India to assess knowledge, perceptions, and practices toward recommended COVID-19 preventive measures, and to explore health-seeking behavior and stigma during early phase of the pandemic. Most participants had knowledge of the signs and symptoms of COVID-19 (94%) and its spread (96%), and reported positive behavior change such as handwashing ≥ 6 times/day (41% pre-COVID-19 vs. 81% during COVID-19, P < 0.001), sneezing or coughing into sleeves (65% pre-COVID-19 vs. 89% during COVID-19, P < 0.001) and staying home if having flu-like symptoms (44% pre-COVID-19 vs. 94% during COVID-19, P < 0.001). We found delayed healthcare seeking for non-COVID-19 illnesses (16%). Fear of losing life was reported by 26% participants, as was discrimination toward migrant returnees, with 35% blaming returnees for the spread of COVID-19. We highlight the need for a holistic approach toward pandemic control, including social and mental health interventions, in public health strategies. [ABSTRACT FROM AUTHOR]

Introduction: Of the total population, elderly people comprised of 8.14% in India where in India or globally. Main challenges faced by the elderly in our country are feminization, ruralisation, migration, and an increasing number of 80‑plus adults. This sudden change of environment or being left stranded alone unattended or being dependent on children for their necessities is a major cause of mental illnesses. Objectives: To study the socio‑demographic profile, find out the different morbidities and assess the health‑seeking behaviour of the study subjects. Materials and Methods: A community‑based cross‑sectional study was conducted in the field practice area of urban health and training center using the simple random sampling method. Results: The mean age of study subjects was 67.58 ± 6.53 years. Majority of participants, i.e., 308 (73.0%) were young old. 207 (49.1%) were illiterate, 272 (64.5%) unemployed 272 (64.5%) and 224 (53.1%) were living with their children, i.e., 224 (53.1%). Inappropriate health‑seeking behavior was significantly associated with under‑weight (P < 0.001) which accounted for 2/3rd of participants. Severe depression was observed among 59.5% participants. Females showed a higher proportion of myalgia (5.7%), whereas males showed preponderance of upper respiratory tract diseases (19.2%). The prevalence of inappropriate health‑seeking behavior was higher in females (65.1%). The proportion of the elderly with poor health‑seeking behavior was found to be 50.4%. Conclusion: Morbidity among the elderly is very high and health‑seeking behavior is very poor. Hence, strong efforts are needed to provide them holistic care. Hence, this study was conducted to threw some light on health status of the elderly, their morbidity pattern and health‑seeking behavior. It will help the policy‑makers to prepare the intervention strategies at the community level. [ABSTRACT FROM AUTHOR]

Background: Although awareness and treatment rates of hypertension have significantly improved in recent years, the prevalence of undiagnosed and untreated hypertension remains a major public health concern for Indian policymakers. While the urban-rural variation in the prevalence, diagnosis, control, and treatment of hypertension is reasonably well-documented, the explanation behind such variation remains poorly understood given the dearth of studies conducted on exploring the determinants of the rural-urban gap in the prevalence of undiagnosed, untreated, and uncontrolled hypertension in India. In view of this research gap, our paper aims to decompose the inter-group differences between rural and urban areas in undiagnosed, untreated, and undertreated hypertension among older adults in India into the major contributing factors.Methods: Nationally representative data collected in the Longitudinal Ageing Study of India, Wave-1 (2017-18), was utilized for this study. Maximum-likelihood binary logistic-regression models were employed to capture the crude and adjusted associations between the place of residence and prevalence of undiagnosed, untreated, and undertreated hypertension. Fairlie's decomposition technique was used to decompose the inter-group differences between rural and urban residents in the prevalence of undiagnosed, untreated, and undertreated hypertension among the older population in India, into the major contributing factors, in order to explore the pathways through which these differences manifest.Results: The overall prevalence rates of undiagnosed, untreated, and undertreated hypertension among older adults were 42.3%, 6%, and 18.7%, respectively. However, the prevalence of undiagnosed and untreated hypertension was higher in rural areas, by 12.4 and 1.7 percentage-points, respectively, while undertreated hypertension was more prevalent in the urban areas (by 7.2 percentage-points). The decomposition analysis explained roughly 41% and 34% of the urban advantage over rural areas in the case of undiagnosed and untreated hypertension, while it explained 51% of the urban disadvantage in respect of undertreated hypertension. The rural-urban differentials in education and comorbidities accounted for the majority of the explained rural disadvantage in the prevalence of undiagnosed hypertension, explaining 13.51% and 13.27% of the gap, respectively. The regional factor was found to be the major driver behind urban advantage in the prevalence of untreated hypertension, contributing 37.47% to the overall gap. In the case of undertreated hypertension, education, comorbidities, and tobacco consumption were the major contributors to the urban-rural inequality, which accounted for 12.3%, 10.6%, and 9.8% of the gap, respectively.Conclusion: Socio-economic and lifestyle factors seemed to contribute significantly to the urban-rural gap in undiagnosed, untreated and undertreated hypertension in India among older adults. There is an urgent need of creating awareness programmes for the early identification of hypertensive cases and regular treatment, particularly in under-serviced rural India. Interventions should be made targeting specific population groups to tackle inequality in healthcare utilization. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rabies, although a 100% fatal disease, is preventable with appropriate post-exposure prophylaxis. A hospital-based cross-sectional study was conducted among 360 animal bite patients in the anti-rabies clinic (ARC) of Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi (VMMC & SJH). Methods: A predesigned, pretested, structured questionnaire was administered by interview technique to assess the sociodemographic profile, health-seeking behavior, and the various domiciliary practices adopted by the animal bite patients. Results: Out of 360 study participants (348; 96.7%) visited a health facility (government/ private) after an animal-bite incident. Of the 241 study participants who washed their wounds, 131 (54.4%) had washed the wound using soap and water and 216 (89.6%) had washed the wound for less than 5 min. Chili paste (128; 35.6%) was the most commonly used household remedy. Interpretation and Conclusions: It was observed that a considerable segment of the study population approached health care facilities for vaccination following animal bite but did not practice the correct wound-washing practices immediately after the incident, and a sizeable proportion of the study participants resorted to non-allopathic practices (e.g., chili paste) as a measure of first aid to manage animal bite wounds. No association was found between the sociodemographic determinants and domiciliary practices and health-seeking behavior (P > 0.05). As rabies is a preventable disease, increasing awareness pertaining to its prevention may prove to be beneficial in reducing the morbidity and mortality. [ABSTRACT FROM AUTHOR]

Early childhood education programs have been found to effectively promote children's social and cognitive development. However, the health impact of these programs is less understood. Using a quasi-experiment of the first universal child care reform in China from 2010, this paper aims to identify whether the preschool reform produces any short-term effects on health-related outcomes of preschoolers (3-6 years old). Specifically, this reform expands access to affordable preschools that provide full-day center-based education, with school meals and essential health services on campus. I exploit the variation in the number of newly established preschools across provinces and implement difference-in-differences and triple-difference strategies. Results confirm the effectiveness of this reform by showing a strong and positive impact on preschool attendance. This paper then documents the benefits to alleviating underweight among preschoolers. Estimates show a larger effect in rural areas, suggesting that the reform narrows rural-urban disparities in education access and undernutrition prevention. I also explore the impact on caregivers' health consciousness and find improved health-seeking behavior when children get sick. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has led to changes in stroke patients' healthcare use. This study evaluated changes in Korean stroke patients' health-seeking behaviors and stroke care services using data from the Korean Stroke Registry (KSR). Methods: We reviewed data from patients with acute stroke and transient ischemic attack (TIA) during 2019 (before COVID-19 period) and 2020 (COVID-19 period). Outcomes included patient characteristics, time from stroke onset to hospital arrival, and in-hospital stroke pathways. Subgroup analyses were performed for an epidemic region (Daegu city and Gyeongsangbuk-do region, the D-G region). Results: The study included 1,792 patients from the pre-COVID-19 period and 1,555 patients from the COVID-19 period who visited hospitals that contribute to the KSR. During the COVID-19 period, the D-G region had two-thirds the number of cases (vs. the pre-CO-VID-19 period) and a significant decrease in the proportion of patients with TIA (9.97%–2.91%). Unlike other regions, the median onset-to-door time increased significantly in the D-G region (361 min vs. 526.5 min, p = 0.016), and longer onset-to-door times were common for patients with mild symptoms and who were in their 60s or 70s. The number of patients who underwent intravenous thrombolysis also decreased during the COVID-19 period, although the treatment times were not significantly different between the 2 periods. Discussion/Conclusion: Korean stroke patients in a CO-VID-19 epidemic region exhibited distinct changes in health-seeking behaviors. Appropriate triage system and public education regarding the importance of early treatment are needed during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The present study aims to explore the common health problems and the healthseeking behavior among the tribal population in Koraput district of Odisha. In order to assess the common health problems and the treatment-seeking behavior, 300 tribal individuals from 173 households in the age group of 18-64 years and 24 health care staff were recruited for the study. Information regarding health facilities, their affordability, and morbidity status were obtained through prestructured questionnaires. Data analysis was carried out using SPSS-20 and Microsoft Excel software tools. Anemia, diarrheal problems, cold, pneumonia, vaginal problems, skin infection, fever, malnutrition, and sickle cell anemia were the common health problems reported by the respondents. In addition, the study found that the majority of the respondents relied on traditional health care practices. The initiation of proper awareness can help in reducing traditional health care practices among the tribal communities. Furthermore, the involvement of modern health care practitioners would help to reduce the disease burden in tribal communities. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the health-seeking behavior and the costs of primary treatment in the immediate aftermath of open globe trauma among patients seeking care at a tertiary eye care center in South India.Methods: This prospective observational study was carried out from June to December 2019. Details of the patient's demographic profile, health-seeking behavior immediately following the trauma and total cost incurred till the completion of primary treatment were collected.Results: Eighty-five patients were recruited. Majority of patients were men (53, 82.8%), came from rural areas (65, 76.4%) and were the main breadwinners (44, 68%) of their family. After the initial trauma, a vast majority of the patients (68, 80%) visited the nearest eye care provider to obtain treatment and a majority of them (47, 69.1%) reached there within 3 h. The remaining patients (17, 20%) came directly to our center, the base hospital (BH). The mean distance travelled to the BH was 113.6 km. The mean total cost incurred was INR 20107.6 ± 10441.3. Approximately 84.8% of the patients reported a monthly income less than this amount.Conclusion: The economic impact of receiving primary definitive care following open globe injuries is higher than the average monthly income of more than 2/3rd of the patients. To replicate the success stories like the cataract outreach programs, there is a need to implement an integrated program encompassing workplace safety, legal protection to primary eye care providers and providing economic support for definitive treatment for the vulnerable population. [ABSTRACT FROM AUTHOR]

Background: With economic development, aging of the population, improved insurance coverage, and the absence of a formal referral system, bypassing primary healthcare facilities appear to have become more common. Chinese patients tend to visit the secondary or tertiary healthcare facilities directly leading to overcrowding at the higher-level facilities. This study attempts to analyze the factors associated with bypassing primary care facilities among patients of age 45 years or older in China.Methods: Random effects logistic models were used to examine bypassing of primary health facilities among rural-urban patients. Data from 2011 to 2015 waves of the China Health and Retirement Longitudinal Study were used.Results: Two in five older patients in China bypass primary health centers (PHC) to access care from higher-tier facilities. Urban patients were nearly twice as likely as rural patients to bypass PHC. Regardless of rural-urban residence, our analysis found that a longer travel time to primary facilities compared to higher-tier facilities increases the likelihood of bypassing. Patients with higher educational attainment were more likely to bypass PHCs. In rural areas, patients who reported their health as poor or those who experienced a recent hospitalization had a higher probability of bypassing PHC. In urban areas, older adults (age 65 years or older) were more likely to bypass PHC than the younger group. Patients with chronic conditions like diabetes also had a higher probability of bypassing.Conclusions: The findings indicate the importance of strengthening the PHCs in China to improve the efficiency and effectiveness of the health system. Significantly lower out-of-pocket costs at the PHC compared to costs at the higher tiers had little or no impact on increasing the likelihood of utilizing the PHCs. Improving service quality, providing comprehensive person-centered care, focusing on family health care needs, and providing critical preventive services will help increase utilization of PHCs as well as the effectiveness and efficiency of the health system. [ABSTRACT FROM AUTHOR]

The health consequences of female genital mutilation (FGM) have been described previously; however, evidence of the social consequences is more intangible. To date, few systematic reviews have addressed the impact of the practice on psycho-social well-being, and there is limited understanding of what these consequences might consist. To complement knowledge on the known health consequences, this article systematically reviewed qualitative evidence of the psycho-social impact of FGM in countries where it is originally practiced (Africa, the Middle East, and Asia) and in countries of the diaspora. Twenty-three qualitative studies describing the psycho-social impact of FGM on women's lives were selected after screening. This review provides a framework for understanding the less visible ways in which women and girls with FGM experience adverse effects that may affect their sense of identity, their self-esteem, and well-being as well as their participation in society. [ABSTRACT FROM AUTHOR]

Health seeking is any activity undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate remedy. Alarmingly, Filipinos have a tendency to delay or ignore preventative health-care measures until the illness becomes evident. While there are numerous studies about health-seeking behavior, studies about the health-seeking behavior of students, especially Filipino nursing students are sparse, hence this choice experiment study. The overall intent of this study is to explicate the health seeking-preferences of a select group of Filipino nursing students. To measure health-seeking preferences, a choice experiment was conducted involving 288 Filipino nursing students enrolled in a college of nursing in the capital of the Philippines. From a pool of 144 orthogonal cards, 16 cards were ranked and sorted by the respondents through the use of Balanced Incomplete Block Design or BIBD. Data were treated descriptively and inferentially using the SPPS version 20. The most important attribute in terms of health-seeking behavior is 'who to consult first.' Filipino nursing students tend to seek health advice from family members when signs and symptoms increase in number, severity, or duration. Results show that 'who to consult first' was conceived to be the most important in seeking health care. The preferred health-seeking behavior of the students, when integrated in health-care services, can improve the quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: Men, more than 50 years of age, have a higher incidence of lower urinary tract symptoms (LUTS), and this increases with the advancing age. The prevalence of LUTS varies in different geographical areas across the world, and studies have reported that LUTS in men may significantly affect the quality of life (QoL) and influence their health-seeking behavior. Early detection of LUTS is essential as it is related to several complications. This study aimed to estimate the prevalence of LUTS and factors associated with LUTS and health-seeking behavior. Methods: We interviewed 201 men (>50 years) attending two urban primary care clinics in Bangalore using the IPSS questionnaire and calculated the prevalence of LUTS. Factors associated with LUTS and health seeking-behavior were tested using the Chi-square test. A P-value less than 0.05 was considered as significant. Results: The prevalence of LUTS was 85%. LUTS was significantly associated with those having diabetes and those consuming more than two cups of tea per day. The most common symptom was nocturia (85.4%) and a weak stream (35.0%). Moderate and severe LUTS were significantly associated with poor QoL score (P < 0.0001). Only 9.3% of the men sought medical help in spite of their symptoms, and the most common reason for seeking health care was the disturbance they had due to the urinary symptoms (81.3%). Conclusions: Family physicians should be aware that a significant proportion of the men in the age group of 50 years suffer from LUTS, and eliciting the same is essential during the process of consultation. [ABSTRACT FROM AUTHOR]

Background: Due to the chronic nature of sickle cell disease (SCD), affected individuals may seek help from diverse places thus raising the need to understand their health-seeking behavior (HSB) in order to design an appropriate management policy for them. Aim: The aim of this study was to evaluate the HSB among pediatric SCD patients relative to their non-SCD counterparts attending a tertiary facility in Southwest Nigeria and identified predictors of poor HSB among SCD patients. Methods: A total of 110 children with SCD were recruited and studied for their HSPs which were compared with 110 non-SCD patients with other chronic medical conditions. Questionnaires were used to obtain self-reported information on participants' socio-demographic data and HSB. Logistic regression was used to determine the predictors of poor HSB among the SCD cohort. Results: More SCD patients received treatments at private hospitals, patent medicine stores and faith-based centers compared to their non-SCD counterparts (p=0.0052; 0.006; and 0.007), respectively. No difference was observed in the patronage of traditional care centres 10 (9.1%) vs 6 (5.5%). More SCD patients 61 (55.5%) vs 35 (31.8%) exhibited poor HSB (p=0.0004). SCD patients who were not enrolled on health insurance scheme were 18 times more likely to have poor HSB (OR=18.38, 95% CI (4.41– 76.57), p value= < 0.0001) while absence of VOC within the preceding year reduces the risk of poor HSB by 91.5% (OR=0.085, 95% CI (0.028– 0.258), p value= < 0.0001). Conclusion: SCD patients in the study locality had poor HSB. This raises the need for their education on proper HSB. More enrollment into health insurance scheme and the prevention of VOC will lessen the burden of poor HSB. The high patronage of non-hospital care facilities in this study raises the need for stakeholders to monitor activities and train the operators at these informal care centres. [ABSTRACT FROM AUTHOR]

A prominent issue in China's healthcare sector is the overcrowding of high-tier hospitals, whereas low-tier hospitals and community health centers are severely underutilized. This study aims to examine whether doctor's visit fee and copay differentiated by the level of healthcare providers can change the distribution of outpatient visits across different levels of healthcare providers. By leveraging the exogeneity of the policy change implemented in a megacity in China in 2017, we apply a parametric discontinuity regression model to study the causal impact of differentiated pricing on patients' health-seeking behavior, using a large-scale insurance claim database. We find that the reform of differentiated doctor's visit fee schedule effectively increases the proportion of visits to primary care facilities among all outpatient visits. This effect is driven by a decline in visits to the highest-tier hospitals and an increase in visits to community healthcare centers. Furthermore, the policy effects are more pronounced among the elderly and people with chronic diseases. Our results suggest that shifting the focus of pricing policies from coinsurance to copays while continuing to improve the capacity of primary care facilities is an effective way to facilitate triaging patients into different levels of care without triggering moral hazard. • A hierarchical doctor's visit fee increases proportion of visits for primary care. • A hierarchical doctor's visit fee increases the demand for low-price physicians. • The effect is more pronounced among elderly and patients with chronic diseases. [ABSTRACT FROM AUTHOR]

Newborn Screening (NBS) is a Philippine government program based on Republic Act 9288 for identification of neonates with genetic, metabolic, or infectious conditions, requiring provision of NBS to all newborns. Despite its passage, NBS provision is grossly underutilized in 2019. This study aims to identify factors influencing maternal utilization of NBS in two PhilHealth accredited Public tertiary hospitals in Quezon City. A sample of 399 mothers was obtained by multi-stage sampling. Logistic regression revealed that the factors that are associated with significant increase of maternal utilization of NBS were Hospital Offer (p < 0.001; OR = 25.629), PhilHealth membership (p = 0.049; OR = 1.677) and Hospital Location (p = 0.001,OR = 2.365) A direct offer of NBS to individual mothers increased maternal utilization of NBS the most; however, PhilHealth membership and hospital systems also played a large role in patient compliance. It is recommended that hospitals assign specific hospital staff to actively offer and be responsible for newborn screening prior to discharge, and that PhilHealth coverage is ensured for all. [ABSTRACT FROM AUTHOR]

Objective: To outline common old age diseases affecting elderly community women of a poor peri-urban area. To identify the type of health services used by the elderly community women. To explore the health seeking behavior of the elderly community women and the factors affecting it. Study Design: It was a descriptive cross sectional study complemented with qualitative study design. Place and Duration of Study: The study was conducted at Farash Town. The duration of study was three months from May 2014 Jul 2014. Methodology: Sample size consisted of 175 respondents. Respondents were selected by convenient sampling. Data was entered into SPSS version 18 for statistical analysis. Frequencies were calculated for the variables. Thirteen semi-structured in-depth interviews were also conducted. For qualitative analysis generated ideas, codes and themes were written. Results: The findings of the study shows that majority of the respondents were from the age group 56-65. One hundred and thirty (74%) of respondents were married, 43 (24%) were widows and only 2 respondent were unmarried. Most of the respondents were illiterate 140 (80%), 30 (17%) were primary pass and 5 (3%) were above Matric. Out of 175 respondents, 169 (97%) were found to be unemployed while only 6 (3%) were working as maid. Locomotor disorders came out to be most prevalent followed by hypertension and diabetes mellitus. One hundred and thirty one (70%) respondents reported themselves unhealthy for which 119 (68%) were taking medicine. Only quarter of respondents were able to get treatment from public sector. The interviews revealed that majority of the respondents reported themselves as sick and weak. Most of them opted for allopathic mode of treatment however affordability was the most common barrier for health seeking among study population. Regarding compliance, only some of the respondents were complying with the treatment. When inquired about the decision-making regarding health seeking, the strongest theme which emerged out was own self as most of the respondents cited themselves as the primary decision makers for their health seeking. Conclusion: Ageing, poverty and immobility complicated by poor access and availability of health care services were the main contributors towards impoverished elderly women health status. The study necessitates the need of obligatory services that could highlight as well as advocate the issued face by elderly women. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI) is common in women in postmenopausal age, but many women delay seeking treatment. The objective of this study is to determine health-seeking behavior of postmenopausal women with UI and its associated factors. This is a cross-sectional study involving 348 postmenopausal women from the outpatient clinic using personal data forms and a validated UI questionnaire. A total of 348 menopausal women were involved in the study. Only 13.17% of patients with UI sought treatment. Factors associated with seeking treatment were age of menopause and severity of UI. More health education needs to be done among these patients. [ABSTRACT FROM AUTHOR]

Older people have been identified to be one of the most vulnerable population groups to the 2019 novel coronavirus (COVID-19). At the same time, more health workers in low-and middle-income countries (LMICs) including Ghana are contracting COVID-19. This poses healthcare utilization concerns for older adults. As a result, many older adults are changing their health-seeking behavior by staying at home and resorting to informal healthcare such as the use of traditional therapies and over-the-counter medicines for self-treatment or to boost their immune system. This commentary calls for social workers to collaborate with health authorities and community pharmacists to develop social and health programs to increase older adults' access to healthcare during the COVID-19 crisis. Policies are also required to deal with the pandemic and its impact on health systems in LMICs for both short and long term. We have suggested in this commentary how governments, health institutions, and local authorities in LMICs can address the healthcare concerns of older adults during this and any future pandemic. [ABSTRACT FROM AUTHOR]

Health-seeking behaviors change during pandemics and may increase with regard to illnesses with symptoms similar to the pandemic. The global reaction to COVID-19 may drive interest in vaccines for other diseases. Our study investigated the correlation between global online interest in COVID-19 and interest in CDC-recommended routine vaccines. This infodemiology study used Google Trends data to quantify worldwide interest in COVID-19 and CDC-recommended vaccines using the unit search volume index (SVI), which estimates volume of online search activity relative to highest volume of searches within a specified period. SVIs from December 30, 2019 to March 30, 2020 were collected for "coronavirus (Virus)" and compared with SVIs of search terms related to CDC-recommended adult vaccines. To account for seasonal variation, we compared SVIs from December 30, 2019 to March 30, 2020 with SVIs from the same months in 2015 to 2019. We performed country-level analyses in ten COVID-19 hotspots and ten countries with low disease burden. There were significant positive correlations between SVIs for "coronavirus (Virus)" and search terms for pneumococcal (R = 0.89, p < 0.0001) and influenza vaccines (R = 0.93, p < 0.0001) in 2020, which were greater than SVIs for the same terms in 2015–2019 (p = 0.005, p < 0.0001, respectively). Eight in ten COVID-19 hotspots demonstrated significant positive correlations between SVIs for coronavirus and search terms for pneumococcal and influenza vaccines. SVIs estimate relative changes in online interest and do not represent the interest of people with no Internet access. A peak in worldwide interest in pneumococcal and influenza vaccines coincided with the COVID-19 pandemic in February and March 2020. Trends are likely not seasonal in origin and may be driven by COVID-19 hotspots. Global events may change public perception about the importance of vaccines. Our findings may herald higher demand for pneumonia and influenza vaccines in the upcoming season. [ABSTRACT FROM AUTHOR]

This is a qualitative exploration of the perceptions of mental health (MH) and their influence on health-seeking behaviour among Syrian refugees and the Lebanese population in Wadi Khaled, a rural area of Lebanon bordering Syria. Eight focus group discussions and eight key informant interviews were conducted with male and female Syrian refugees and Lebanese community members from March to April 2018. MH illness was associated with stigma, shame and fear among both populations. Beliefs surrounding mental illness were strongly linked to religious beliefs, including Jinn. Religious healers were considered the first line of help for people with mental illnesses, and were perceived as culturally acceptable and less stigmatizing than MH professionals. It is essential for MH professionals to build trust with the communities in which they work. Collaboration with religious healers is key to identifying MH symptoms and creating referral pathways to MH professionals in this context. [ABSTRACT FROM AUTHOR]

Background: Cambodia is among the 30 countries in the world with the highest burden of tuberculosis (TB), and it is estimated that 40% of people with TB remain undiagnosed. In this study, we aimed to investigate the determinants of delayed diagnosis and treatment of TB in Cambodia. Methods: This mixed-method explanatory sequential study was conducted between February and September 2019 in 12 operational districts in Cambodia. It comprised of a retrospective cohort study of 721 people with TB, followed by a series of in-depth interviews. We assessed factors associated with time to TB diagnosis and treatment initiation using Cox proportional hazards model. Subsequently, we conducted in-depth interviews with 31 people with TB purposively selected based on the time taken to reach TB diagnosis, sex, and residence. Transcripts were coded, and thematic analyses were performed. Results: The median time from the onset of symptoms to TB diagnosis was 49 days (Interquartile range [IQR]: 21–112). We found that longer time to diagnosis was significantly associated with living in rural area (Adjusted hazards ratio [aHR] = 1.25; 95% confidence interval [CI]: 1.06–1.48); TB symptoms—cough (aHR: 1.52; 95% CI: 1.18–1.94), hemoptysis (aHR 1.32; 95% CI: 1.07–1.63), and night sweats (aHR: 1.24; 95% CI: 1.05–1.46); seeking private health care/self-medication (aHR: 1.23; 95% CI: 1.04–1.45); and higher self-stigma (aHR: 1.02; 95% CI: 1.01–1.03). Participants who received education level above the primary level were inversely associated with longer time to diagnosis (aHR: 0.78; 95% CI: 0.62–0.97). The median time from TB diagnosis to the initiation of treatment was two days (IQR: 1–3). The use of smear microscopy for TB diagnosis (aHR: 1.50; 95% CI: 1.16–1.95) was associated with longer time to treatment initiation. Seeking private health care and self-medication before TB diagnosis, lack of perceived risk, threat, susceptibility, and stigma derived qualitatively further explained the quantitative findings. Conclusions: TB diagnostic delay was substantial. Increasing public awareness about TB and consciousness regarding stigma, engaging the private healthcare providers, and tailoring approaches targeting the rural areas could further improve early detection of TB and narrowing the gap of missing cases in Cambodia. [ABSTRACT FROM AUTHOR]

Background: Social Health Insurance (SHI) is widely used by countries attempting to move toward Universal Health Coverage (UHC). While evidence suggests that SHI is a promising strategy for achieving UHC, low-income countries often struggle to implement and sustain SHI systems. It is therefore important to understand how SHI enrollees use health insurance and how it affects their health-seeking behavior. This paper examines how SHI affects patient decision-making regarding when and where to seek care in Kenya and Ghana, two countries with established SHI systems in sub-Saharan Africa.Methods: This paper draws from two datasets collected under the African Health Markets for Equity (AHME) program. One dataset, collected in 2013 and 2017 as part of the AHME qualitative evaluation, consists of 106 semi-structured clinic exit interviews conducted with patients in Ghana and Kenya. This data was analyzed using an inductive, thematic approach. The second dataset was collected internally by the AHME partner organizations. It derives from a cross-sectional survey of social franchise clients at three social franchise networks supported by AHME. Data collection took place from February - May 2018 and in December 2018.Results: Many clients appreciated that insurance coverage made healthcare more affordable, reported seeking care more frequently when covered with SHI. Clients also noted that the coverage gave them access to a wider variety of providers, but rarely sought out SHI-accredited providers specifically. However, clients sometimes were charged for services that should have been covered by insurance. Due to a lack of understanding of SHI benefits, clients rarely knew they had been charged inappropriately.Conclusions: Clients and providers would benefit from education on what is included in the SHI package. Providers should be monitored and held accountable for charging clients inappropriately; in Ghana this should be accompanied by reforms to make government financing for SHI sustainable. Since clients valued provider proximity and both Kenya and Ghana have a dearth of providers in rural areas, both countries should incentivize providers to work in these areas and prioritize accrediting rural facilities into SHI schemes to increase accessibility and reach. [ABSTRACT FROM AUTHOR]

The article examines public perceptions of capitation payment system and the implications for health-seeking behavior in rural and urban Ghana. Drawing on qualitative approach, the study employed focus groups (n = 20), in-depth (n = 20), and key informant (n = 14) interviews with community-based adult men and women, aged 18–65 years in Ashanti Region. Tape recorded interviews were transcribed and analyzed thematically. Results indicated that majority of respondents have heard about the capitation but only a small proportion of them understood what the whole policy entails and the rationale for its introduction. While general dissatisfaction with and negative perceptions of the capitation still persisted among majority of the study population, this did not translate into nonuse of health services. For subscribers to derive optimal benefits from the capitation, political commitment in continuing public education using the most accessible media modulation is key. More importantly, public and private healthcare providers should increase investments in improving healthcare delivery system. Future studies should employ quantitative approaches with region-wide sample in order to confirm the relationships between capitation enrollment and health-seeking behavior. [ABSTRACT FROM AUTHOR]

Background: Before choosing/visiting any dental facility for their treatment, patients consider several factors. These factors may be related to the patient or service provider. The health‑seeking behavior of a society defines how health services are used. Aims: To assess the health seeking behavior of patients with premalignant lesions. Material and Method: A cross sectional study using questionnaire was done among the patients who consulted in the Department of Oral Medicine and Radiology, of age 18 and above suffering from precancerous lesions. The questionnaire included 25 close‑ended questions which collected information about the demographic details, oral hygiene habits, oral health issues, deleterious habits. The responses were either on dichotomous scale (yes and no) or on the frequency habits. A total of 218 subjects were included in the study. The data were analyzed using the Chi‑square test. The acceptable level of significance was reduced to P < 0.05. Result: Slightly over 50% of study participants visited the dentist for their dental problems. Most of the participants visited dental clinic whenever needed. Maximum positive health seeking behavior is seen in fourth and fifth decade and minimum seen in second and third decade. Conclusion: The oral premalignant lesions have high chances of transformation into malignancies. The progression of these lesions can be prevented by stopping the progression at an early stage and thus instilling positive health seeking behavior serves as an important key to it. [ABSTRACT FROM AUTHOR]

Background: In spite of high prevalence rates, little is known about health seeking and related expenditure for chronic non-communicable diseases in low-income countries. We assessed relevant patterns of health seeking and related out-of-pocket expenditure in Bangladesh.Methods: We used data from a household survey of 2500 households conducted in 2013 in Rangpur district. We employed multinomial logistic regression to assess factors associated with health seeking choices (no care or self-care, semi-qualified professional care, and qualified professional care). We used descriptive statistics (5% trimmed mean and range, median) to assess related patterns of out-of-pocket expenditure (including only direct costs).Results: Eight hundred sixty-six (12.5%) out of 6958 individuals reported at least one chronic non-communicable disease. Of these 866 individuals, 139 (16%) sought no care or self-care, 364 (42%) sought semi-qualified care, and 363 (42%) sought qualified care. Multivariate analysis confirmed that the following factors increased the likelihood of seeking qualified care: a higher education, a major chronic non-communicable disease, a higher socio-economic status, a lower proportion of chronic household patients, and a shorter distance between a household and a sub-district public referral health facility. Seven hundred fifty-four (87 %) individuals reported out-of-pocket expenditure, with drugs absorbing the largest portion (85%) of total expenditure. On average, qualified care seekers encountered the highest out-of-pocket expenditure, followed by those who sought semi-qualified care and no care, or self-care.Conclusion: Our study reveals insufficiencies in health provision for chronic conditions, with more than half of all affected people still not seeking qualified care, and the majority still encountering considerable out-of-pocket expenditure. This calls for urgent measures to secure better access to care and financial protection. [ABSTRACT FROM AUTHOR]

Introduction: The safety and health of the sanitary workers are an important issue in the current situation. They are the most vulnerable population as they are exposed to hazardous materials affecting the health. This study aims to assess the morbidity profile of the sanitary workers and health-seeking behavior of the workers. Materials and Methods: This is a descriptive cross-sectional study done among the 99 sanitary workers in the tertiary care hospital selected by universal sampling technique. A semi-structured questionnaire was used to collect the data after taking the informed consent from the participants. Data were collected and analyzed using SPSS software version 22. Results: Among the workers, 57.6% of them were =44 years of age and 48.5% of them were uneducated. About 24.2% of the workers were in this same occupation for more than 5 years and 87.9% of the workers were using protective equipment while working. The prevalence of musculoskeletal morbidities was high (68.7%) when compared to the other medical morbidities. Only 5.1% of the workers availed health services for the existing health problems. Conclusion: This study concluded that the musculoskeletal morbidities were high among the sanitary workers when compared with other medical morbidities. Most of the people did not avail health-care facilities. Hence, necessary steps such as health education and screening can be given to improve the quality of life among the sanitary workers. [ABSTRACT FROM AUTHOR]

Persons struggling with housing remain significantly disadvantaged when considering access to health care. Effective advocacy for their needs will require understanding the factors which impact their health care, and which of those most concern patients themselves. A qualitative descriptive study through the lens of a transformative framework was used to identify barriers and facilitators to accessing health care as perceived by people experiencing homelessness in the regional municipality of Niagara, Canada. In-person, semi-structured interviews with 16 participants were completed, and inductive thematic analysis identified nine barriers and eight facilitators. Barriers included affordability, challenges finding primary care, inadequacy of the psychiatric model, inappropriate management, lack of trust in health care providers, poor therapeutic relationships, systemic issues, and transportation and accessibility. Facilitators included accessibility of services, community health care outreach, positive relationships, and shelters coordinating health care. Knowledge of the direct experiences of marginalized individuals can help create new health policies and enhance the provision of clinical care. [ABSTRACT FROM AUTHOR]

Purpose: This study examines the associations between financial inclusion, health-seeking behavior, and health-related outcomes in older persons in Ghana. Method: Employing data from a 2016/2017 Aging, Health, Psychological Well-Being and Health-Seeking Behavior Study (N = 1,200; mean age = 66.2 years [standard deviation = 11.9], we estimated regression models of self-rated health (SRH), psychological distress (PD), and health-care use (HCU) on a variable representing compositional characteristics of financial inclusion. Results: Multivariate logistic and generalized Poisson models showed that financial inclusion is positively associated with SRH (β =.104, standard error [ SE ] =.033, p <.001) but inversely related to both PD (β =.038, SE =.032, p <.005) and HCU (β = −.006, SE =.009, p <.05) independent of other factors. However, after adjusting for socioeconomic and health-related factors, the associations were tempered and the effect of SRH decreased by 0.094 and PD increased by 0.065 points but HCU became statistically insignificant (β = −.020, SE =.0114, p >.05) Conclusions: Financial services inclusion profoundly appears to buffer against and retard health-related challenges in later life. Social and health policies targeted at improving the health outcomes of older people should include and build on the growing recognition of the importance of inclusive financial services and strategies. [ABSTRACT FROM AUTHOR]

The tribal people are more tradition bound and have poorer health indicators with limited access to healthcare services. However, with changing time and continuous effort of the government, they are now in a transitional phase of shifting from traditional to modern healthcare practices. This article attempts to explore context, reasons, and options behind the health-seeking behavior of the Tangsa (Hill Tribe) women of Margherita sub-division of Tinsukia district, Assam, along with their access to the public healthcare services. Using both simple random and purposive sampling method, primary data were collected in the field from the married women, adolescent girls, and mothers who have girl child of 0-9 years of age from two Tangsa villages, namely Kharangkong and Hassak. Data were collected using standard field methods, for example, observation, survey schedule, interview, semi-structured and open-ended questionnaires, case study, and participatory tools such as focused group discussion (FGD). The findings indicate that Tangsa women generally prefer traditional healing practices to cure many of the common diseases. But a portion of women ranging from 42 to 74 percent received the benefits from different government health schemes related to reproductive health. Institutional delivery is gradually increasing, but iron and folic acid (IFA) intake by pregnant women and adolescent girls is still very poor. The public health department should make more effort to increase the level of awareness and knowledge among the tribal women about the benefits that can be availed from various schemes and modern healthcare services. [ABSTRACT FROM AUTHOR]

Background: There is scarce scientific data on topical corticosteroids (TCS) prescription by non-dermatologists including registered medical practitioners, ayurvedic, homeopathic practitioners, and over-the-counter (OTC) use of TCS-containing creams. Objective: The main objective of this study is to analyze the prescription and usage pattern of topical steroids among out-patient attendees with dermatophyte infection. To study health-seeking behavior of patients with dermatophyte infections. Material and Methods: An open, cross-sectional, duration-based study of 3 months. Inclusion criteria: Patients with dermatophytosis having a history of topical steroid application; either prescribed or purchased OTC and used themselves. Exclusion criteria: Patients who were not willing to give informed consent. Patient's data like socio-demographic profile, duration, frequency, site of application, contents of the topical cream used, prescriber information, and patients' desire to continue the use of topical steroids were recorded. Results: Total of 18.40% (n = 503) patients were already using cream-containing TCS at the time of presentation to the tertiary dermatology care center. The study shows that almost half of the patients (48.90%) were using unprescribed TCS. Registered medical practitioners were the most common source of TCS creams prescription (59.92%) in the prescribed group, while 26.07% patients were prescribed TCS by dermatologists. Clobetasol propionate (47.91%), was most common steroid agent used. Conclusion: Patients are able to get "prescription-only" drugs as OTC products. Such OTC use of TCS puts patients at risk of steroid modified dermatophytosis and topical steroid damaged skin. Even dermatologists may be culprit in creating menace of steroid abuse. [ABSTRACT FROM AUTHOR]

Background: The under-five children are a vulnerable age group; their mortality reflecting a country's overall development. Timely and appropriate healthcare seeking behavior, if practiced by caregivers, can have a significant impact on survival. The slum dwellers have poor health-seeking behavior due to their lower socioeconomic status, prevailing malnutrition, poor immunization status, overcrowding, poor sanitation, personal and cultural practices, beliefs, and attitude toward healthcare providers. Objectives: (1) To assess the health-seeking behavior among caregivers of under-five children during acute childhood illness (2) To find out the factors associated with their treatment-seeking behavior. Materials and Methods: A community-based cross-sectional study, among 260 caregivers, in the field practice area of Urban Health and Training Centre of a medical college was undertaken from September 1, 2016 to February 28, 2017, using a pretested semistructured questionnaire after obtaining a list of under-fives from the female health worker. Results: In total, 260 caregivers with mean of 26.61 ± 4.31 years participated in the study, 77.69% reported of some health morbidity. Around 21.92% of the caregivers gave primary care at home, 33.46% visited a chemist, and 33.08% attended health facility nearby. About 79.23% sought healthcare immediately following illness. Of the remaining 20.77% who did not seek medical advice, 75.93% used home remedies. Significant association was found between the age of the mother, educational status of the mother, religion, birth order of the child and socioeconomic status of the caregivers, and appropriate treatment seeking behavior during an episode of acute illness. Conclusion: This study attempted to identify health-seeking behavior of caregivers for children under-five and the determinants of appropriate treatment-seeking behavior. The knowledge of signs and symptoms of ill-health can reduce morbidity and mortality; however, continuous education of caregivers for recognition of symptoms and the need to seek appropriate medical care is needed. Government facility was the preferred choice for the population in the sampled slum. Treatment-seeking behavior was good among the respondents with majority having appropriate behavior. Measures can be taken to help promote awareness among those who did not have appropriate treatment seeking behavior. [ABSTRACT FROM AUTHOR]

Background: Nowadays, in light of gender inequity, new concern has been raised for health-seeking behavior of women in clinical setting. The aim of this study was to investigate the perceptions and health-seeking behaviors of Afghan immigrant women residing in Mashhad, Iran. Method: An ethnographic design was used to examine the health-seeking behavior of Afghan women. This study took place in Tollab Tabarsi area of Mashhad, Iran, from March 2013 to July 2014. For gathering of data, participant observations, fieldwork, and formal interviews were included. Data were analyzed using thematic analysis. Results: Fourteen Afghan women immigrants and five health care professionals were interviewed. The overarching category derived from the data was gender inequity. The emergent three themes were cultural taboos, women position, and information gap. Discussions: The displaced Afghan women were found to be at significant risk of adverse health events, which affected both their physical health and mental health. [ABSTRACT FROM AUTHOR]

Abstract The United Nations Convention on the Rights of Persons with Disabilities recognizes the rights of persons with disabilities' access to health care, including primary health care (PHC). However, growing evidence indicates that individuals in rural areas generally experience health access issues, and these issues are even worse for those with physical disabilities. Knowledge about such experiences is critical for policy design and clinical practice to promote PHC access for persons with physical disabilities in rural areas. This study seeks to explore the experiences of persons with physical disabilities in accessing PHC services in the predominantly rural Upper West Region of Ghana. We conducted semi-structured interviews with 18 participants living with physical disabilities, and used both deductive and inductive approaches to analyze the data. Participants shared experiences at three broad levels: the health system level, individual level and health-seeking behaviors level. Within the health system level, we identified three main categories: service availability (presence of health facilities, deficient drug supply and lack of providers), acceptability (positive and negative attitudes of providers and perceived high and low quality of care) and accommodation (inaccessible health facilities and equipment). The experiences at the individual level included financial constraints and mobility to health care facilities. Health-seeking behaviors related to how the individual reacted and responded to access barriers, which included searching for traditional healing, resorting to self-medication, making sacrifices in managing their conditions and relying on spiritual means. The information provided in this study is potentially important to policy makers and PHC providers as it presents evidence on the barriers and facilitators to PHC access in a rural setting. In particular, understanding individuals' experiences and how they develop health-seeking behaviors to overcome access barriers will be critical for policy design and client-centered service delivery in rural Ghana and potentially other low- and middle-income countries. Highlights • Persons with physical disabilities face barriers in accessing primary health care. • Barriers occur at both the individual and health care system levels of scale. • Clients develop different health-seeking behaviors to overcome access barriers. [ABSTRACT FROM AUTHOR]