Factors affecting health-care seeking behaviour, and assessment of the population's perception of the major health problems in Gauteng province, South Africa 2013
Abaerei, Admas Abera
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 educational status. 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 IV 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.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Epidemiology. Johannesburg, June 2016
Major Health Problems