Health Seeking Behavioural Practices of the Elderly in Rural Community of Ekiti State, South-western Nigeria

BackgroundThe ageing process increases the risks of contracting a disease among elderly people. Health-seeking behaviour is poor among the aged in sub-Saharan countries like Nigeria, escalating the burden of Non-communicable diseases and the cost of healthcare which further impact the utilization of Orthodox medicine. This study aims to assess the healthcare-seeking behavioural practices and associated factors among elderly people in Ido-Ekiti.MethodA descriptive cross-sectional study was conducted amongst 420 elderly respondents in Ido-Ekiti. An interviewer-administered semi-structured questionnaire was used to collect information. The data collected were analyzed using SPSS version 25 and results were presented in form of tables and bar charts. Chi-square tests were used to test for associations. All data analysis was done at a 5% level of significance.ResultsThe age range of respondents was between 65-95 years with a mean age of 73.88 +/- 6.84 years and 64.0% within the age range 65-75 years. About 63.3% of the respondents have had an episode of illness in the last year preceding the study and only 35.3% consulted a doctor for treatment (Good Health seeking behaviour), however, 57.9% admitted utilizing any of the following; self-medication, consult spiritualist, use of herbal medicine (poor health-seeking behaviour). The factors statistically significantly associated with respondents’ health-seeking behavioural practices are employment status(p<0.001), educational level (p<0.002), cost of health care, access to the health facility, length of time before consultation, beliefs, and lack of support from relations(p<001). ConclusionThis study shows the majority of elderlies had poor health-seeking behaviour due to educational and .economic factors. Making the free or subsidized cost of health care for the elderly in rural communities and the provision of monthly financial support to the aged by the government will promote and encourage good health-seeking behaviour of old people.

EFFECT OF SCHOOL-BASED EDUCATIONAL INTERVENTIONS ON DEPRESSION-RELATED HEALTH-SEEKING BEHAVIOUR AMONG IN-SCHOOL ADOLESCENTS IN OGUN STATE, NIGERIA.

Introduction: Depression is one of the most common mental health diseases among adolescents; the repercussions are penetrating and are visible later in life. Purpose: To determine the effectiveness of school-based educational interventions on depression-related health-seeking behaviour among in-school adolescents in Ogun state, Nigeria. Methodology: A quasi-experimental design comprising of one control group and three experimental groups was conducted. Health Belief Model (HBM) was used for the study. The population of the study was 120 in-school adolescents selected using the multi-stage sampling technique from four (4) selected secondary schools. A validated semi-structured questionnaire was used for data collection. Data collected was coded using IBM® SPSS version 23. Data were analyzed using descriptive and inferential statistics at 0.05 level of significance. Findings: The mean±SD ages of the adolescents in the teacher-led, peer-led, teacher-led and peer-led and control groups were 14.43±2.315 years, 14.33±1.605 years, 14.97±1.426 years and 15.43±1.960 years in the teacher-led, peer-led, teacher and peer-led and control groups respectively. Equal number of female and male students were in the teacher-led group but different in other groups 19 (63.3%), 19 (63.3%) and 16 (53.3%). Results established that the students recruited for this study shared similar socio-demographic characteristics. The findings revealed that adolescent’s level of depression health-seeking behaviour significantly increased after the intervention. The teacher-led group had greater health-seeking behaviour scores (mean difference=24.27; effect size=16.04, t = 75.123; p = 0.000). Conclusion and Recommendation: The study established that teacher-led educational intervention had the greatest effect size and change in the level depression health-seeking behaviour among adolescents. This reinforces the opinion that teachers are often able to provide adolescents with key support in which they play the role of mentors in schools. Contribution to theory, practice and policy: The findings of this study which used the HBM theory support the premise that interventions based on theories are effective in influencing behaviour change in which health educators can utilize. A combination of intervention may also be important in influencing specific changes of adolescents’ mental health behaviours. Policy briefs with the study’s findings and concise summary should be communicated to the policy makers with follow up to aid updating mental health policies available.

Liberalising Health-seeking Behaviour of the Johanne Marange Apostolic Sect in Manicaland, Zimbabwe

Religious rights as enshrined in the Zimbabwean constitution are sacrosanct, however, when church doctrine bars followers from seeking modern medical care, they start infringing on health rights especially of the ‘lesser beings’ the women and children who are members of these religious sects. The ‘lesser beings’ are bearing the brunt of high maternal and neonatal mortality as they depend on unsafe traditional birth attendants and unconventional medicine. This study is ethnographic and presents lessons learnt from a programme aiming to improve maternal, newborn and child health outcomes among the Apostolic Church of Johanne Marange members in Manicaland province, Zimbabwe. The findings show that despite the stringent doctrine and barriers placed on apostolic members who want to access conventional medicine, the women and children are using clandestine approaches to circumvent the doctrine and barriers. This article argues that a barrage of unconventional and conventional approaches can lead to changes in health-seeking behaviour of the apostolic church and ultimately maternal and child health outcomes. The article argues that the intransigence of the apostolic can only be overcome by covert approaches to providing health services and save lives.

Parents’ experiences with a sick or injured child during the COVID-19 lockdown: an online survey in the Netherlands

ObjectiveTo assess the impact of the COVID-19 lockdown on parents’ health-seeking behaviour and care for a sick or injured child in the Netherlands.Design and settingAn online survey on parents’ experiences with a sick or injured child during the COVID-19 lockdown periods was disseminated through social media.ParticipantsParents living in the Netherlands with a sick or injured child during the lockdown periods from March to June 2020 and from December 2020 to February 2021 were eligible to participate.Outcome measuresDescriptive statistics and thematic analysis were used to analyse family and children’s characteristics, parents’ response to a sick or injured child, and the perceived impact of the lockdown on child’s severity of illness and treatment reported by parents. Analyses were stratified for children with and without chronic conditions.ResultsOf the 105 parents who completed the survey, 83% reported they would have sought medical help before lockdown compared with 88% who did seek help during lockdown for the same specific medical problem. Parents reported that changes in health services affected their child’s severity of illness (31%) and their treatment (39%), especially for children with chronic conditions. These changes included less availability of healthcare services and long waiting lists, which mostly led to worsening of the child’s illness. During lockdown, there was no change in health-seeking behaviour by parents of children with a chronic condition (N=51) compared with parents of children without a chronic condition.ConclusionParents in the Netherlands who completed the survey were not deterred from seeking medical help for their sick or injured child during the COVID-19 lockdown periods. However, changes in health services affected child’s severity of illness and treatment, especially for children with chronic conditions.

The power of "altruistic" healthcare and its impacts on the health-seeking behaviour of Korean immigrants in New Zealand

<p>Immigrants’ health-seeking behaviours are reconstructed during their healthcare adapting process as a consequence of interaction with the host health services. How Korean immigrants, who came from a very different healthcare system, reconstructed their health-seeking behaviours by adapting in New Zealand, and the factors affecting their healthcare decisions and behaviours were the main concerns of the research. Korean immigrants’ experiences were explored and theorised in order to provide a theoretical understanding of their health-seeking behaviours. Glaser’s classic grounded theory was used to generate a conceptual theory with emergent fit. Forty-eight participants were recruited from Wellington and Auckland. The primary data were collected from unstructured face-to-face individual interviews (n=23), seven two-person interviews (n=14 [two people attended twice]), and four group interviews (n=14 [one person attended twice]). In order to develop a theory grounded in the participants’ experiences and perspectives, data were collected, coded and analysed congruently and iteratively with the constant comparison and theoretical sampling methods. The Healthcare Acculturation Theory that emerged from this research elucidated Koreans’ healthcare adapting process and provided insights into their health-seeking behaviours in New Zealand. Koreans’ health-seeking behaviours were largely categorised into four positions: “rejecting”, “attuning”, “attuning but negotiating”, and “rejecting but negotiating”. They were found to be in one of the four positions at any one point in time and each position reflected their responses toward the New Zealand healthcare system. Once a specific position was held, their healthcare decisions and behaviours were directed by the said position. As their healthcare experiences were ongoing, their chosen positions were not end-outcomes in themselves. When their existing perceptions and behaviours were challenged by new experiences their healthcare positions transitioned or reinforced, and these changes informed the Healthcare Acculturation Theory. When Korean immigrants, who came from a commercially driven healthcare system, experienced healthcare (emergency care rather than elective) at the public services in New Zealand they were deeply touched. The healthcare they received was caring, empathetic, and responsive care delivered in a person-centred way that they had never experienced before. This experience rendered a turning point in their healthcare adapting process. Participants who reached such a point experienced transitions, not only in their healthcare positions, but in their life beliefs and values as well, which went far beyond simply a shifting perspective but can be likened more to a “conversion”. It was conversion to a new understanding. This research articulates the major contributing factor to immigrants’ acceptance of healthcare, which was receiving care that Koreans perceived as “altruistic”. It is related to the ambience of health services that resulted in sincere and empathetic care, rather than the barriers to healthcare that immigrants face in the host country. This thesis makes an important contribution to the existing body of knowledge on acculturation demonstrating new knowledge and a theoretical understanding of health-seeking behaviour, in the development of a substantive theory based on the experiences of Korean immigrants in New Zealand.</p>

The power of "altruistic" healthcare and its impacts on the health-seeking behaviour of Korean immigrants in New Zealand

<p>Immigrants’ health-seeking behaviours are reconstructed during their healthcare adapting process as a consequence of interaction with the host health services. How Korean immigrants, who came from a very different healthcare system, reconstructed their health-seeking behaviours by adapting in New Zealand, and the factors affecting their healthcare decisions and behaviours were the main concerns of the research. Korean immigrants’ experiences were explored and theorised in order to provide a theoretical understanding of their health-seeking behaviours. Glaser’s classic grounded theory was used to generate a conceptual theory with emergent fit. Forty-eight participants were recruited from Wellington and Auckland. The primary data were collected from unstructured face-to-face individual interviews (n=23), seven two-person interviews (n=14 [two people attended twice]), and four group interviews (n=14 [one person attended twice]). In order to develop a theory grounded in the participants’ experiences and perspectives, data were collected, coded and analysed congruently and iteratively with the constant comparison and theoretical sampling methods. The Healthcare Acculturation Theory that emerged from this research elucidated Koreans’ healthcare adapting process and provided insights into their health-seeking behaviours in New Zealand. Koreans’ health-seeking behaviours were largely categorised into four positions: “rejecting”, “attuning”, “attuning but negotiating”, and “rejecting but negotiating”. They were found to be in one of the four positions at any one point in time and each position reflected their responses toward the New Zealand healthcare system. Once a specific position was held, their healthcare decisions and behaviours were directed by the said position. As their healthcare experiences were ongoing, their chosen positions were not end-outcomes in themselves. When their existing perceptions and behaviours were challenged by new experiences their healthcare positions transitioned or reinforced, and these changes informed the Healthcare Acculturation Theory. When Korean immigrants, who came from a commercially driven healthcare system, experienced healthcare (emergency care rather than elective) at the public services in New Zealand they were deeply touched. The healthcare they received was caring, empathetic, and responsive care delivered in a person-centred way that they had never experienced before. This experience rendered a turning point in their healthcare adapting process. Participants who reached such a point experienced transitions, not only in their healthcare positions, but in their life beliefs and values as well, which went far beyond simply a shifting perspective but can be likened more to a “conversion”. It was conversion to a new understanding. This research articulates the major contributing factor to immigrants’ acceptance of healthcare, which was receiving care that Koreans perceived as “altruistic”. It is related to the ambience of health services that resulted in sincere and empathetic care, rather than the barriers to healthcare that immigrants face in the host country. This thesis makes an important contribution to the existing body of knowledge on acculturation demonstrating new knowledge and a theoretical understanding of health-seeking behaviour, in the development of a substantive theory based on the experiences of Korean immigrants in New Zealand.</p>

AWARENESS OF STD AND HEALTH SEEKING BEHAVIOUR: A COMMUNITY BASED STUDY IN THE URBAN SLUMS OF JORHAT DISTRICT, ASSAM

Sexually transmitted diseases (STD) are transmitted from one person to another through sexual contact, caused by bacteria, viruses or parasites. STDs are becoming a major public health problem in India. The objective of this paper is to determine the prevalence of awareness of STD among the youth age group of 15-24 years old residing in the urban slum of Jorhat town. The study shows that in the age group 15-19 years, 62% individuals were not aware about STDs while about 52% were not aware in the age group 20-24 years. The present study reveals that only about 61% individuals opined that STDs are transmissible and only 42% say that STD is preventable. It is concluded from the study that majority of the individuals in the study group are unaware about STD's.

Knowledge of Brucellosis, Health-Seeking Behaviour, and Risk Factors for Brucella Infection amongst Workers on Cattle Farms in Gauteng, South Africa

Brucellosis in humans is under-detected and underreported in sub-Saharan Africa. Risk factors associated with Brucella infection and health seeking behaviour in response to brucellosis-like symptoms, amongst cattle farm workers and veterinary officials in South Africa, are unknown. Farm workers and veterinary officials (N = 230) were screened for brucellosis using commercial Rose Bengal Test (RBT®), IgM Enzyme-linked Immunoassay (ELISA)®, IgG ELISA® and the BrucellaCapt® test. Knowledge of brucellosis and risk factors for exposure to Brucella were also investigated. Seroprevalence varied according to test used: 10.1% (RBT®), 20.9% (IgG ELISA®) and 6.5% (BrucellaCapt®). Only 22.2% (6/27) of veterinary officials opt to visit a clinic, doctor, or hospital in response to self-experienced brucellosis-like symptoms, compared to 74.9% (152/203) of farm workers (p < 0.001). Of the BrucellaCapt® seropositive participants, 53% (7/15) did not visit a clinic in response to brucellosis-like symptoms. Weak evidence of an association between the handling of afterbirth or placenta and infection of a short evolution (RBT®, IgM ELISA® and IgG ELISA® seropositive) was found (OR = 8.9, 95% CI: 1.0–81.1, p = 0.052), and strong evidence of an association between this outcome and the slaughter of cattle (OR = 5.3, 95% CI: 1.4–19.6, p = 0.013). There was strong evidence of a positive association between inactive/resolved infection and veterinary officials vs. farm workers exposed to seropositive herds (OR = 7.0, 95% CI: 2.4–20.2, p < 0.001), with a simultaneous negative association with the handling of afterbirth or placenta (OR = 3.9, 95% CI: 1.3–11.3, p = 0.012). Findings suggest a proportion of undetected clinical cases of brucellosis amongst workers on cattle farms in Gauteng.