Please note: Digitised content is made available at the best possible quality range, taking into consideration file size and the condition of the original item. These restrictions may sometimes affect the quality of the final published item. For queries regarding content of ETD collection please contact Tshidi Letswalo by email : Tshidi Letswalo or Tel : 011 717 1922
Background: More than a billion people, mainly in low- and middle-income countries (LMICs), are
unable to access needed health care services for a variety of reasons. Possible factors influencing
health-care seeking behaviour are socio-demographic and economic factors such as age, sex,
ethnicity, religion, education and employment; and income and expenditure levels, and other cultural
or political factors. There are limited studies on health-care seeking behaviour especially of
vulnerable populations such as immigrants in South Africa.
Aim of the study: To assess factors associated with health care seeking behaviour, and to assess the
population’s perception of major health problems and its determinants in Gauteng Province, South
Africa in 2013.
Methods: We conducted secondary data analysis of data from a Quality of Life (QoL) survey
carried out by Gauteng City-Region Observatory (GCRO) to determine factors associated with
health care seeking behaviour and perception of major health problems among adults living in
Gauteng province. We used Coarsened Exact matching (CEM) to improve estimation of causal
effects. A multiple logistic regression model was used to identify factors associated with health care
seeking behaviour and multinomial logistic regression was employed to determine factors associated
with perception of major health problems.
Results: From a total of 27 490 participants interviewed, a total of 26 318 (95.7%) participants
reported usually utilizing health care services while the remaining 4.3% reported not having sought
health care services of any type, when they needed. In addition 141 (0.5%) reported having visited
traditional healers when they are ill. Higher odds of reported health care seeking was associated with
being white compared to being African (Odds Ratio (OR) =2.28 95% CI: 1.84 - 2.74; p<0.001); with
having medical insurance compared to not having any (OR=5.41 95% CI: 4.06 - 7.23; p<0.001). In
contrast, lower odds of seeking health care was associated with being an immigrant compared to
being a citizen of Republic of South Africa (OR=0.61 95% CI: 0.53 - 0.70; p<0.001) and being
employed compared to being unemployed (OR=0.84 95% CI: 0.72 - 0.97; p=0.02). the perception
of major health problems was significantly associated with age, sex, population group and
Conclusion: Age and sex of participants, population group, immigration status and
presence/absence of health insurance were associated with health care seeking behaviour. There is a
need to improve the quality of public health care services and perception towards them as improved
health care quality increases the choice of health care provider relative to either going to traditional
healers or self-treatment. Furthermore, health education and health promotion campaigns should
focus on creating continuous awareness especially about chronic diseases and their risk factors.