Begashaw Bayu, Tessema Fasil, Gesesew Hailay Abrha
Department of Public Health, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia.
Department of Epidemiology, Jimma University, Jimma, Oromiya, Ethiopia.
PLoS One. 2016 Sep 14;11(9):e0161014. doi: 10.1371/journal.pone.0161014. eCollection 2016.
Rural and urban populations have disparate socio-demographic and economic characteristics, which have an influence on equity and their health seeking behavior. We examined and compared the health care seeking behavior for perceived morbidity between urban and rural households in Southwest Ethiopia.
Analytic cross-sectional study was conducted among urban and rural households living in Esera district of Southwest Ethiopia. A random sample of 388 head of households (126 urban and 262 rural) were selected. A pretested and structured questionnaire was used for data collection with face-to-face interview. In addition to descriptive methods, binary logistic regression was used to identify factors associated with health seeking behavior at p value of less than 0.05.
Of the sample household heads, 377 (97.2%) (119 urban and 258 rural) were successfully interviewed. Among these, 58.4% (95% CI, 53.3-63.3%) of the households sought care from modern health care that was lower among rural (48.1%) than urban (80.7%) households. The prevalence of self-treatment was 35.3% in urban and 46.1% in rural households. Among the factors considered for modern health care utilization, higher monthly income (AOR, 5.6; 95% CI, 2.04-15.4), perceived severity of disease (AOR, 2.5; 95% CI, 1.1-5.8), acute duration of disease (AOR, 8.9; 95% CI, 2.4-33.3) and short distance from health facilities (AOR, 3; 95% CI, 1.2-8.4) among rural and being married (AOR, 11.3; 95% CI, 1.2-110.2) and perceived severity of disease (AOR, 6.6; 95% CI, 1.1-10.9) among urban households showed statistically significant association.
The general health seeking behavior of households on perceived morbidity was satisfactory but lower in rural compared to urban households. Self-medication was also widely practiced in the study area. The findings signal the need to work more on accessibility and promotion of healthcare seeking behavior especially among rural households.
农村和城市人口具有不同的社会人口统计学和经济特征,这对公平性及其就医行为产生影响。我们调查并比较了埃塞俄比亚西南部城乡家庭对感知到的发病率的就医行为。
在埃塞俄比亚西南部埃塞拉区的城乡家庭中进行了分析性横断面研究。随机抽取了388户家庭户主(126户城市家庭和262户农村家庭)。使用经过预测试的结构化问卷通过面对面访谈收集数据。除描述性方法外,采用二元逻辑回归来确定p值小于0.05时与就医行为相关的因素。
在样本家庭户主中,377人(97.2%)(119户城市家庭和258户农村家庭)成功接受了访谈。其中,58.4%(95%CI,53.3 - 63.3%)的家庭寻求现代医疗服务,农村家庭(48.1%)低于城市家庭(80.7%)。城市家庭自我治疗的患病率为35.3%,农村家庭为46.1%。在考虑现代医疗服务利用的因素中,农村家庭月收入较高(调整后比值比[AOR],5.6;95%CI,2.04 - 15.4)、感知疾病严重程度(AOR,2.5;95%CI,1.1 - 5.8)、疾病急性病程(AOR,8.9;95%CI,2.4 - 33.3)以及距离医疗机构较近(AOR,3;95%CI,1.2 - 8.4),城市家庭已婚(AOR,11.3;95%CI,1.2 - 110.2)和感知疾病严重程度(AOR,6.6;95%CI,1.1 - 10.9)显示出统计学上的显著关联。
家庭对感知到的发病率的总体就医行为令人满意,但农村家庭低于城市家庭。自我用药在研究地区也很普遍。研究结果表明需要在提高可及性和促进就医行为方面做出更多努力,特别是在农村家庭中。