Online Program

Healthcare expenditure, quality and accessibility as differentials in health-seeking behavior among women in rural India

Monday, November 4, 2013

Apurv Soni, BA, Department of Health Sciences, Boston University, Boston, MA
Nisha Fahey, BA, Department of Health Sciences, Boston University, Boston, MA
Ajay Phatak, MSc, MPH, Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India
Somashekhar Nimbalkar, MD, Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India
Eileen O'Keefe, MD, MPH, Department of Health Sciences, Boston University, Boston, MA
Background: Healthcare-seeking behavior is affected by socio-economic, physical and cultural factors. Understanding these factors improves access to healthcare and focuses the development of health programs. Determinants that influence and differentiate healthcare-seeking behaviors for mothers compared to their child(ren) were studied. Methods: Cross-sectional health survey of women, 18-45 years, conducted by female interviewers in a hospital and sixteen surrounding villages in rural Gujarat, India. Respondents were asked the reason for postponing healthcare when they need it and those with a living child were asked the same regarding their child(ren). Results: Of 681 respondents, 493 reported having at least one living child. A majority of all respondents (57.4%) reported that they postpone healthcare. Mothers were less likely to postpone their child(ren)'s healthcare than their own (44.7% v. 60%). Of the mothers who postpone their own healthcare, 191 (64%) identified cost as the primary reason. In contrast, of those who postponed their child(ren)'s healthcare, only 72 (32.5%) did so because of cost (χ2,p<0.0001). Quality of care was more frequently the reason in postponing healthcare for children by mothers (25%) than for themselves (9.5%) (χ2,p<0.0001). Multivariate analysis indicates that impact of healthcare expenditure on family spending is the strongest predictor of healthcare-seeking behavior. Conclusions: Understanding the rationale and barriers for deferring healthcare is critical to improving access to care and reducing morbidity and mortality. Initiatives that address quality and perception of healthcare along with the burden of healthcare expenditure on family economics will be most effective and utilized by poor rural populations in India.

Learning Areas:

Public health or related public policy

Learning Objectives:
Identify factors that influence health-seeking behavior of women for themselves and their child(ren). Differentiate health-seeking behaviors of women for themselves and their child(ren). Define barriers that women face in seeking healthcare for themselves and their child(ren) when necessary.

Keyword(s): Barriers to Care, International MCH

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was involved in the conceptual design of the research study, implemented the research study in Gujarat, India and led the analysis as well as the writing of the manuscript related to differential in health care seeking behavior among mothers and their children. A scientific and personal interest of mine is to use evidence based findings to guide health policy and outreach in underserved and underprivileged settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.