Illness incidence and health seeking behaviour among street children in Rawalpindi and Islamabad, Pakistan - a qualitative study

Background This is the first study in Pakistan to elicit street children's perceptions of health and the barriers to service utilization. Methods A descriptive, cross-sectional study was carried out during September and October 2000. The data were collected in twin-cities of Rawalpindi and Islamabad through individual, semi-structured street-based interviews; with 40 school age participants; in addition, three focus group discussions were also completed. The sampling was convenience based. This strategy was applied because of the non-existence of a sampling frame for the street-based children owing to the absence of any census or other reports, and also the difficulty of tracking very mobile street children. Results Results indicate that these youth were highly susceptible to many adverse health outcomes. The common ailments were injuries, respiratory and skin infections. Along with low self-perceived severity of medical problems, self-medication was preferred and medical pluralism existed. Their perceived constraints to services included long waiting time, monetary, negative attitude of service providers and their inferior status. Conclusions In developing user-friendly services, it is important to be sensitive to street children's needs and requirements. Eliminating these barriers and the integration of health services among public and private resources are imperative for the regular and sustainable provision of health care to this vulnerable, under-served group of children.