Self-reported Seasonal Symptoms and Diseases and Primary Healthcare Utilization Among Rural Elderly Women in Sylhet District, Bangladesh.

The physical health and conditions of elderly people are challenged by the adverse effects of seasonal variations in sub-tropical countries, including Bangladesh. Research to date does not feature the risk of seasonal changes for primary healthcare infrastructures and practices in supporting elderly women's care, especially in rural areas. This study aims to identify the health effects of seasonal variations that place increased risk of symptoms and diseases on rural elderly women, and to explore the determinants associated with the women's use of healthcare locally. Using a mixed-methods approach, audio-recorded semi-structured interviews including a short survey with sixty-five rural elderly women and eleven healthcare professionals were conducted. Quantitative data were analyzed in SPSS, and a thematic analysis of the qualitative data was facilitated by NVivo. Self-reported health history by rural elderly women identified the prevalence of three major seasonal symptoms: headache (28/43.1%), digestive disorder (27/41.5%), and physical pain (27/41.5%). The prevalence of three symptoms such as nausea, headache and digestive disorder varied significantly (p < 0.05) across the study villages. Of the women, the age group (60-70 years) recorded the highest number of cases (20), followed by age group (71-80 years/15), where the number of cases significantly varied across three seasons (p = 0.021). While 78.5% and 55.4% reported one and two symptoms/diseases respectively, the community clinic visits differed significantly (p = 0.011) among the seasons. The utilization of primary healthcare was low, and marginalization in using healthcare was underpinned by the health system, the poor living conditions of the women, and their reluctance to seek treatment. The findings suggest a need for policy solutions in promoting preventive measures and treatments by strengthening local clinics and on-going health education and training of staff and elderly women.