Health seeking behavior refers to decision or an action taken by an individual to maintain, attain, or regain good health and to prevent illness. Health seeking behavior determines how different classes of people use health services from the health professionals and the health service organizations.
A number of factors that determine health seeking behavior are: physical, socio-economic, cultural and political (Musoke et al. 2015; Mahmood et al. 2009, p. 6; Kroeger 1983). The health status and health care service in developing countries are determined by the socio economic status and the affordability and utilization of the health facilities (Guru et al. 2015). So, investigation of socio-economic factors is one of the vital issues in health services in Bangladesh.
The effectiveness of a health system depends on the availability and accessibility of services in a form which the people are able to understand, accept and utilize (Islam and Biswas 2014). However, a large number of the people in Bangladesh, particularly in rural areas, remain with little access to health care facilities (Islam and Biswas 2014). Osman (2008) study found that the factors that contribute to poor accessibility of health care in developing countries are illiteracy, poverty, poor funding of the health sector, inadequate water and poor sanitation facilities. Mahejabin et al., (2015) study found that health seeking behavior in different socio-economic levels of any community is crucial for proper planning and implementing of effective health services, particularly for poor community.
Education is one of the factors that reduce infant mortality (NIPORT 2013). Empirical studies from Bangladesh and few other developing countries found that socio-economic condition is highly considerable factors in health seeking behavior (Biswas et al. 2006).
Socio-demographic factors such as age is a factor which varies the health care seeking behavior from person to person. A study of Engeda et al., (2016) found that age was significantly associated with visiting modern health care facility. In contrast, Amin et al., (2010) study examined that age and education factors were less pronounced in the differentials of health seeking behavior of maternal care and child health care in rural Bangladesh (Amin et al. 2010). Sun et al., (2013) found that health literacy is also affected by prior knowledge and age; the effect from prior knowledge is positive and that from increasing age is negative. Health literacy is a direct influencing factor of health behavior, but its effect is weaker than that of prior knowledge.
Engeda et al (2016) demonstrates that the more the educational level of people is, the better their understanding of diseases processes, availability of diagnosis, treatment options, and the risk of delay in medical care seeking will be. Sun et al., (2013) explains education is one of the powerful tools that affect seeking of health services. Bashar et al (2012) found a significant relationship (p < 0.05) between level of education with malaria prevalence which was conducted in Bangladesh. Mahoood et al (2009) presents the health-seeking behaviour of the people in Chakaria, a rural area in Bangladesh. The results show that treatment seeking was not equitable throughout the community. A clear gender differential in treatment seeking was observed in the area. The study showed that although more females reported being ill compared to males, treatment seeking was significantly higher among males compared to the females (Mahmood et al. 2009). The study Ahmed (2005) found socioeconomic indicators were the single most pervasive determinant of health-seeking behavior among the study population, overriding age and sex, and in case of health-care expenditure, types of illness as well. Qasim et al., (2014) reviewed the literature related to health seeking behavior and socio economic factor of women. They observed that there were the two main reasons for not seeking help, one is lack of finances (Qasim et al. 2014; Uddin et al., 2014) to access any health service and another is considering the symptom as something common not needing attention. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of health literacy where health literacy helps individuals to make effective use of available health services. According to Uddin et al., (2014), the quality of medical treatment was associated with urbanity and type of disease. The findings of the study show that seeking medical treatment from any provider in the last one year was higher in the rural than urban patients (Uddin et al. 2014). Amin et al., (2010) conducted a study where data collected from three divisions of Bangladesh and the major findings was that a household’s relative poverty status, as reflected by wealth quintiles, was a major determinant in health-seeking behavior (Amin et al., 2010). This finding supports by the study of Uddin et al. (2014) as they examined that household asset quintile was the primary determinant of consulting trained providers in both sites; the higher the asset quintile the higher was the consultation rate. Mothers in the highest wealth quintile were significantly more likely to use modern trained providers for antenatal care, birth attendance, post natal care and child health care than those in the poorest quintile (Amin et al. 2010). Amin et al (2010) study found that both formal education and relative wealth were positively associated with the utilization of maternal and child health services. So, they suggested based on the findings that, both the economic and educational improvement of the poor mothers would have a reinforcing effect on improved service utilization, so they both need to be strengthened.
Understanding health seeking behavior will assist to know how socio-economic inequalities in developing societies contribute to unequal health services. So, research on health seeking behavior is immediately required to ensure need based health care to the different segment of population. This study will examine some significant health service determinants such as socio-economic and demographic factors which are correlated with health seeking behavior. Some examples include gender, age, education, access to health, income, traditional beliefs and modern health care system (Islam et al 2006; Islam and Biswas 2014; NIPORT 2013). The study of Tipping and Segall (1995) also demonstrated that the decision to engage with a particular medical channel is influenced by a variety of socio-economic variables, including sex, age, the social status of women, the type of illness, access to services and perceived quality of the service.
This study hypothesizes that the level of socioeconomic factors increase the inequalities in health seeking behavior and also the degree of socio-demographic factors have a causal relationship with health care seeking treatment. Health seeking behavior is viewed as the varied response of individuals to states of ill-health, depending on their knowledge and perceptions of health, socioeconomic constraints, adequacy of available health services and attitude of healthcare providers (Afolabi et al. 2013).
Several studies stated that the various factors that influence the health service delivery and seeking behavior in rural and urban areas, causes of health inequalities, and poor accessibility of health in developing countries. But none of studies have been found on how socio-economic and demographic factors contribute to health seeking behavior and health inequalities particularly in poor resource setting urban areas in Bangladesh.
The following sections describe the methods and materials used in the study. After this section, detail results of this research have been explained. The final section concludes discussion and policy recommendations for this study.