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Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India
BACKGROUND: To control the double burden of communicable and non-communicable diseases (NCDs), in the developing world, understanding the patterns of morbidity and healthcare-seeking is critical. The objective of this cross-sectional study was to determine the distribution, predictors and inter-rela...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428703/ https://www.ncbi.nlm.nih.gov/pubmed/25965382 http://dx.doi.org/10.1371/journal.pone.0125865 |
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author | Kanungo, Suman Bhowmik, Kalyan Mahapatra, Tanmay Mahapatra, Sanchita Bhadra, Uchhal K. Sarkar, Kamalesh |
author_facet | Kanungo, Suman Bhowmik, Kalyan Mahapatra, Tanmay Mahapatra, Sanchita Bhadra, Uchhal K. Sarkar, Kamalesh |
author_sort | Kanungo, Suman |
collection | PubMed |
description | BACKGROUND: To control the double burden of communicable and non-communicable diseases (NCDs), in the developing world, understanding the patterns of morbidity and healthcare-seeking is critical. The objective of this cross-sectional study was to determine the distribution, predictors and inter-relationship of perceived morbidity and related healthcare-seeking behavior in a poor-resource setting. METHODS: Between October 2013 and July 2014, 43999 consenting subjects were recruited from 10107 households in Malda district of West Bengal state in India, through multistage random sampling, using probability proportional-to-size. Information on socio-demographics, behaviors, recent ailments, perceived severity and healthcare-seeking were analyzed in SAS-9.3.2. RESULTS: Recent illnesses were reported by 55.91% (n=24600) participants. Among diagnosed ailments (n=23626), 50.92% (n=12031) were NCDs. Respiratory (17.28%,n=7605)), gastrointestinal (13.48%,n=5929) and musculoskeletal (6.25%,n=2749) problems were predominant. Non-qualified practitioners treated 53.16% (n=13074) episodes. Older children/adolescents [adjusted odds ratio for private healthcare providers(AOR(Pri))=0.76, 95% confidence interval=0.71-0.83) and for Govt. healthcare provider(AOR(Govt))=0.80(0.68-0.95)], females [AOR(Govt)=0.80(0.73-0.88)], Muslims [AOR(Pri)=0.85(0.69-0.76) and AOR(Govt=)0.92(0.87-0.96)], backward castes [AOR(Govt)=0.93(0.91-0.96)] and rural residents [AOR(Pri)=0.82(0.75-0.89) and AOR(Govt)=0.72(0.64-0.81)] had lower odds of visiting qualified practitioners. Apparently less severe NCDs [acid-peptic disorders: AOR(Pri)=0.41(0.37-0.46) & AOR(Govt)=0.41(0.37-0.46), osteoarthritis: AOR(Pri)=0.72(0.59-0.68) & AOR(Govt)=0.58(0.43-0.78)], gastrointestinal [AOR(Pri)=0.28(0.24-0.33) & AOR(Govt)=0.69(0.58-0.81)], respiratory [AOR(Pri)=0.35(0.32-0.39) & AOR(Govt)=0.46(0.41-0.52)] and skin infections [AOR(Pri)=0.65(0.55-0.77)] were also less often treated by qualified practitioners. Better education [AOR(Pri)=1.91(1.65-2.22) for ≥graduation], sanitation [AOR(Pri)=1.58(1.42-1.75)] and access to safe water [AOR(Pri)=1.33(1.05-1.67)] were associated with healthcare-seeking from qualified private practitioners. Longstanding NCDs [chronic obstructive pulmonary diseases: AOR(Pri)=1.80(1.46-2.23), hypertension: AOR(Pri)=1.94(1.60-2.36), diabetes: AOR(Pri)=4.94(3.55-6.87)] and serious infections [typhoid: AOR(Pri)=2.86(2.04-4.03)] were also more commonly treated by qualified private practitioners. Potential limitations included temporal ambiguity, reverse causation, generalizability issues and misclassification. CONCLUSION: In this poor-resource setting with high morbidity, ailments and their perceived severity were important predictors for healthcare-seeking. Interventions to improve awareness and healthcare-seeking among under-privileged and vulnerable population with efforts to improve the knowledge and practice of non-qualified practitioners probably required urgently. |
format | Online Article Text |
id | pubmed-4428703 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-44287032015-05-21 Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India Kanungo, Suman Bhowmik, Kalyan Mahapatra, Tanmay Mahapatra, Sanchita Bhadra, Uchhal K. Sarkar, Kamalesh PLoS One Research Article BACKGROUND: To control the double burden of communicable and non-communicable diseases (NCDs), in the developing world, understanding the patterns of morbidity and healthcare-seeking is critical. The objective of this cross-sectional study was to determine the distribution, predictors and inter-relationship of perceived morbidity and related healthcare-seeking behavior in a poor-resource setting. METHODS: Between October 2013 and July 2014, 43999 consenting subjects were recruited from 10107 households in Malda district of West Bengal state in India, through multistage random sampling, using probability proportional-to-size. Information on socio-demographics, behaviors, recent ailments, perceived severity and healthcare-seeking were analyzed in SAS-9.3.2. RESULTS: Recent illnesses were reported by 55.91% (n=24600) participants. Among diagnosed ailments (n=23626), 50.92% (n=12031) were NCDs. Respiratory (17.28%,n=7605)), gastrointestinal (13.48%,n=5929) and musculoskeletal (6.25%,n=2749) problems were predominant. Non-qualified practitioners treated 53.16% (n=13074) episodes. Older children/adolescents [adjusted odds ratio for private healthcare providers(AOR(Pri))=0.76, 95% confidence interval=0.71-0.83) and for Govt. healthcare provider(AOR(Govt))=0.80(0.68-0.95)], females [AOR(Govt)=0.80(0.73-0.88)], Muslims [AOR(Pri)=0.85(0.69-0.76) and AOR(Govt=)0.92(0.87-0.96)], backward castes [AOR(Govt)=0.93(0.91-0.96)] and rural residents [AOR(Pri)=0.82(0.75-0.89) and AOR(Govt)=0.72(0.64-0.81)] had lower odds of visiting qualified practitioners. Apparently less severe NCDs [acid-peptic disorders: AOR(Pri)=0.41(0.37-0.46) & AOR(Govt)=0.41(0.37-0.46), osteoarthritis: AOR(Pri)=0.72(0.59-0.68) & AOR(Govt)=0.58(0.43-0.78)], gastrointestinal [AOR(Pri)=0.28(0.24-0.33) & AOR(Govt)=0.69(0.58-0.81)], respiratory [AOR(Pri)=0.35(0.32-0.39) & AOR(Govt)=0.46(0.41-0.52)] and skin infections [AOR(Pri)=0.65(0.55-0.77)] were also less often treated by qualified practitioners. Better education [AOR(Pri)=1.91(1.65-2.22) for ≥graduation], sanitation [AOR(Pri)=1.58(1.42-1.75)] and access to safe water [AOR(Pri)=1.33(1.05-1.67)] were associated with healthcare-seeking from qualified private practitioners. Longstanding NCDs [chronic obstructive pulmonary diseases: AOR(Pri)=1.80(1.46-2.23), hypertension: AOR(Pri)=1.94(1.60-2.36), diabetes: AOR(Pri)=4.94(3.55-6.87)] and serious infections [typhoid: AOR(Pri)=2.86(2.04-4.03)] were also more commonly treated by qualified private practitioners. Potential limitations included temporal ambiguity, reverse causation, generalizability issues and misclassification. CONCLUSION: In this poor-resource setting with high morbidity, ailments and their perceived severity were important predictors for healthcare-seeking. Interventions to improve awareness and healthcare-seeking among under-privileged and vulnerable population with efforts to improve the knowledge and practice of non-qualified practitioners probably required urgently. Public Library of Science 2015-05-12 /pmc/articles/PMC4428703/ /pubmed/25965382 http://dx.doi.org/10.1371/journal.pone.0125865 Text en © 2015 Kanungo et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Kanungo, Suman Bhowmik, Kalyan Mahapatra, Tanmay Mahapatra, Sanchita Bhadra, Uchhal K. Sarkar, Kamalesh Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India |
title | Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India |
title_full | Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India |
title_fullStr | Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India |
title_full_unstemmed | Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India |
title_short | Perceived Morbidity, Healthcare-Seeking Behavior and Their Determinants in a Poor-Resource Setting: Observation from India |
title_sort | perceived morbidity, healthcare-seeking behavior and their determinants in a poor-resource setting: observation from india |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428703/ https://www.ncbi.nlm.nih.gov/pubmed/25965382 http://dx.doi.org/10.1371/journal.pone.0125865 |
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