Factorsaffecting on Health Seeking Behavior and Utilization of Health Care Servicesamong Married Rural Dalit WomenAbstract:”Health iswealth” is a popular saying in almost over the world. Imperatively the attitudeto pay attention to the health is often determined by health seeking behaviorparticularly the encouraging and discouraging factors of people thought.

Therefore the present study tried to analyze the factors affecting on HealthSeeking Behavior of married Rural Dalit Women. The current study was carriedout in Tumkur rural district. Descriptive research design was adopted to fulfill the framedobjectives. With the help of convenient sampling technique, 120 respondentswere selected as sample size. Self-structured questionnaire was adoptedfollowed by the personal interview. Both primary and secondary data wascollected.

The collected primary data was computed by applying simplestatistical percentage analysis method. The study found low socio-economiccondition had significant impact on health seeking behavior and health care access. Further the study alsofound neglected attitude towards health were the major factors affecting healthseeking behavior among the rural Dalit women.KeyWords: Health,Health seeking behavior, Dalit women. Introduction:Women health status issues have been gained higher internationalrecognisation and renewed political commitment almost in all the countries ofthe world in recent decades. The ongoing policies and programs have enableswomen to lead healthier lives. Many socio –economic barriers also dispirit themto search out services from the government, non-government and private healthcare settings access necessary health care (UNICEF, 2009).

Health behavior are actions people take to be awareof the health state to sustain an optimal state of health by preventing illnessand injury and reach their maximum physical and mental potential. Healthseeking behaviors are those acts people engage to be healthy. Women healthproblem are ubiquitous in the country (Rahman, Md.

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Habibur, parveen, & Giedraties, 2016) Dalitwomen of India have been living in the culture of silence throughout thecenturies. They have remained mute expectators to their exploitation,oppression and barbarity against them. They do not have any control over theirown bodies, earnings, and lives. The extreme expression of violence,exploitation and oppression against them is visible in forms of hunger,malnutrition, disease, physical and mental torture, rape; illiteracy,ill-health, unemployment, insecurity and inhuman treatment.

 (Ghatak, 2011). It evidentlyreflects the poor health status of the Dalitwomen. Tanveer Ahmad Dar and R.Saravanan (2015) have revealed that the health status and utilizationpattern of scheduled tribes gives an indication of their social exclusion aswell as an idea of their linkages between poverty and health. The study foundthat, Dalits  have poor level of awareness about their healthand health care system, even the communities and inhabitants.

The majorimpediment  in the poor health conditionof the them was non-acceptance of professional doctors  in their community. Though, disinclinedattitude to seek aid for health issues stayed significant problem among Dalits along with two other majorproblems such as inaccessibility and unaffordable health care. The healthseeking behaviour of a community determines how they use health care services. Utilizationof health facilities can be influenced by the cost of services, distance tohealth facilities, cultural beliefs, level of education and health facilityinadequacies such as stock-out of drugs (David, Boyton, Butler, & Musoke, 2014). Thus their healthstatus depends on many factors. Hence it is important to understand the majorfactors of health seeking behavior of the Dalitcommunity.

Therefore the present study is strived to find out the factorsaffecting on the health seeking behavior among the Dalits.Factorsaffecting health seeking behaviorMultifaceted of factors have been recognized as theleading causes of poor health seeking behavior and utilization of health careservices such as  poor socio-economicstatus, lack of physical accessibility, cultural beliefs and perceptions, lowliteracy level of the mothers and large family size. Review of the globalliterature suggests that these factors can be classified as cultural beliefs,socio-demographic status, women’s autonomy, economic conditions, physical andfinancial accessibility, and disease pattern and health service issues  (Babar & Hatcher, 2004).This complexity is reflected in thehealth seeking behaviour, including the use of home-prescriptions, delay in seekingbio-medical treatment and non-compliance with treatment and with referraladvice. The attitude of the health provider and patient satisfaction with thetreatment play a role in health seeking behaviour.

 (Babar & Hatcher, 2004)Objectivesof the study·        To study the socio-economic condition ofthe respondents·        To analyze the factors affecting onhealth seeking behavior and utilization of health care services among the ruralDalit women in tumkur district.Methodology:The present study was carried out in tumkur ruralarea among the Dalit women. Theobjective of the study is to analyze the factors affecting on health seeking behaviorand utilization of health care services among the rural Dalit women in tumkur district. The study is based oncross-sectional study. Purposive sampling techniques was used by adopting 120respondents. Interview was followedto collect the primary data. Data on general demographic and socio-economiccharacteristics, health seeking behavior and utilization of health care serviceswere asked was collected. Data was computed by analyzing thesimple statistical percentage  method.

Resultsand conclusion:                           Table.No.1 Socio-Economic condition of the respondents  Sl.

No Particulars Responses Percentage 1 Age 21 to 40 58 % 41 to above 42% 2 Marriage at the age Below 18 19% 19 to 25 40% 26 to 30 25% 30 to 35 16% 3 Education Qualification Illiterate 8% Primary 27% High school 45% Pre-University 12% Degree 8% 4 Occupation House wife 49% Clerical work 2% Day labour 46% Others 3% 5 Monthly income of the Husband 2001 to 4000 12% 4001 to 6000 68% 6001 to 8000 13% 10,000 to 15 000 7% The above table indicating the respondentssocio-economic condition profile of the respondents specifically, age, marriageat the age, Educatio qualification, occupation, and monthly income of therespondents. Majority 58% of the respondents were aged between 21to 40 years and rest 42 per cent of the respondents were aged to 41 years toabove.Among the 120 respondents 40% of the respondentswere married at the age of 19 to 25 years, 25% of the respondents were marriedbetween the age group of 26 to 30 years. Followed 19% and 16 % of therespondents were got married at the age of below 18 years and 30 to 35 years.Around 59 % of the respondents were married between the age group of 18 to 25years. Majority 45% ofthe respondents  were studies upto highschool, 27%  of the respondents werecompleted their primary education, 12 % of the respondents were donepre-university college,  8% of therespondents were  educated up graduationand rest 8% of the respondents were illiterate.

Majority 49% of therespondents were housewife, 46% of the respondents were works has day laborerin other farms, this was the major occupation for their livelihood.  2% of them were occupied with clerical workand 3% of them were working in other type of work.From the abovetable it could be seen that, majority 68% of the respondents were receivingRs.

4001 to 6000 as monthly income of the husband. 13% were drawing Rs.6001 to8000, rest 7% of the respondents were receiving Rs.10000 to 15,000 as a monthlyincome. It could understand that majority of the respondents were monthlyincome starts form Rs.2001 to 8000.

Most of the women wereworks as day labour in other farms.From the above table, it was found majority of therespondents were young and middle age. It was also found that 19% of them weremarried at below 18 years of age. Marriage before 18 years may affects on womenhealth by increased risk for sexually transmitted diseases, childbirth, andobstetric fistulas etc,.

Majority of them were finished high-school barely theycan able to read and write. Majority half of them were working whereas 49% ofthem were home makers. Half of the respondents were earning Rs.4001 to 6000 astheir husbands monthly income. Overall the socio-economic condition of therespondent s were average.Table2. Behavior factors for Health seeking behavior Sl.

No Particulars Responses Strongly Agree Agree Neither agree nor Disagree Disagree Strongly disagree Total 1 Health Consciousness/ Family health consciousness 27% 56% 7% 8% 2% 100% 2 Knowledge about the health and illness 18% 25% 25% 31% 1% 100% 3 Low  payment as doctor fee  for health Check up at private   40%   27%   31%   2% 0% 100% 4 Affordable cost from public health settings 8% 59% 29% 4% 0% 100% 5 Lack of access to government health care centers avoids health seeking behavior 67% 14% 12% 7% 0% 100% 6 Personal dislikes to visit government hospital 43% 26% 21% 10% 0% 100% 7 Shyness to disclose the disease 61% 11% 12% 16% 0% 100% 8 Dependency on others 73% 11% 16% 11% 9% 100%  From the above table section gives detail of thebehavior of the 120  respondents. Furtherthe  table depicts the behavioral factorswhich makes  the respondents to seekhealth care,  particularly on healthconsciousness, knowledge about the health and illness, family health conscious,low payment as doctor fee for health check up at private hospital/clinic andaffordable cost from public health settings etc.,Majority 56 per cent of the respondents werestrongly agreed that their health consciousness influence them to seek healthcare facility.

8 per cent of the respondents were disagreed, 7 per cent of themneither agreed nor disagreed and 2 per cent of them were disagreed to it. Among the 120 respondents respectively 25 per centand 25 per cent of the respondents were equally agreed and stayed neutral tothe statement of knowledge about the health and illness influences them to seekhealth care, 31 per cent of them were strongly disagreed, 18 per cent of themwere strongly agreed, rest 1% of the them were strongly disagreed. Majority 40 per cent of them were  strongly agreed that, low payment as doctorfee for health check up at private clinic influencing them to seek  health care. Followed 27% , 31% and 2% ofthem were respectively agreed, neither agreed nor disagreed, and disagreed toit.Majority 59 per cent of them were  agreed, 29% of the respondents were agreednor disagreed, remaining 8% and 4% percent of them were disagreed that,affordable cost of public health settings also plays vital role in influencingthe women to seek health care.Majority i.

e, 67% of the respondents strongly agreedthat, lack of access to government health care centers in near the areaprevents them to seek health care. 14% of them were agreed and 12% of therespondents neither agreed nor disagreed remaining 7% of  them were disagreed to it.It was also significantly noted that, 43% of therespondents were strongly agreed that they had personal dislikes to visitgovernment hospitals, 26% of them also agreed and 21% of them were neutral only10% of them were disagreed to it.  Peoplebelief status on government hospital treatment is not good. They suspect thetreatment results.The table imperative states that, majority 61% ofthe respondents were hesitate to access health care because of shyness attitudetowards disclosing the disease. 11% of them were opined agree, 12% of them werestayed neutral and rest 16% of them were disagreed to it.

Majority of them donot like to disclose the disease and scare to know their health statusMajority i.e 73% of them strongly agreed they dependon other to take them to hospital, 11% of them were agreed, 16% of them neutral11% of them were disagreed to it. As per the respondents opinion most the womenwere depends on other family members aid to visit hospital, they scared aboutthe hospital admission and diagnostic procedures and expects  the presence of  one of their family member with themFrom the above analysis it was found that, healthconscious significantly influence them to seek health care and itsutilization,  specifically  low doctoral fee at private clinic, healthconscious of selves/family, knowledge about the health and illness, affordablecost  in the public health settings  are the motivational behavior factors  for health seeking behavior. Factors such aspersonal dislikes to visit government hospital, shyness to disclose the disease,dependency on others to take them to hospital and majorly lack of access togovernment health care canters avoids health seeking behavior among them.Table.

3Utilization of Health care among the respondents during ill health Sl. No Particulars Responses Always Sometimes Rare Total 1 Used Health facility at primary health center 22% 67% 11% 100% 2 Health facility at private doctors 41% 42% 17% 100% 3 Used pharmacy drug 76% 13% 11% 100% 4 Used traditional healer 29% 62% 9% 100% 5 Self treatment with local herbs 44% 38% 18% 100%  From the above table it manifests the utilization ofhealth care services among the respondents during the period of ill health. Majority67% of the respondents were opined sometimes they use health facility atprimary health center, 22% of them were always and only 11% of them were rarelyutilizes the primary health centers.  Itwas orally omitted by the respondents that, they can not find the doctor in allthe days, they have prejudiced about the government hospitals. Majority 76% ofthe respondents were always used to take pharmacy drug during ill health.Followed 13% and 11% of them were sometimes and rarely go for pharmacy drug.

Majority 62% of the respondents were sometimes go for traditional healer, rest 29% and 9% of them visit totraditional healer always and rare. 44% of the respondents were always takesself treatment with local herbs for minor disease, Limitationof the studyThe main limitation of this study is that thefindings are limited in terms of generalization and impact since it was a studyconducted in one rural community. There may also have been recall bias whenresponding to some of the questions asked. Nevertheless, the data providesuseful information on the health seeking behavior and challenges in utilizinghealth facilities in rural communities in Tumkur Rural district.Conclusion:The study found health seeking behavior and healthconscious among the Dalit community isvery poor. Changing health seeking behavior and promoting increased usage ofhealth care services, among Dalitcommunity is also reflected in National family Health survey report 3 and 4.Several studies also reveal the poverty and neglected behavior of health werethe main obstacles for poor health status. Series of social work interventionmay bring change in the behavior and ensure to utilize the proper health carefacility.

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