Socio-demographic correlates of the health-seeking behaviours in two districts of Pakistan's Punjab province

Objective: To explore socio-demographic correlates of the health-seeking behaviours among urban and rural population. Methods: A population-based cross-sectional study was conducted in two districts of Pakistan's Punjab province with a random multi-stage cluster sample of 1080 individuals. Bivariate analysis using chi-square test and Fisher's exact test was used as the test of trend. Multivariate logistic regression was used to obtain adjusted odds ratio (OR) with 95% confidence interval (Cl). Statistical significance was considered at P<0.05. Results: Utilization of the public health facilities (74%) was associated with rural area (P=0.034) and poverty (P=0.001) while use of the private hospitals (41%) was associated with better education (P=0.002) and higher income (P<0.001). When simultaneously adjusted for area, income and education, the poor were more likely to use the public hospitals (OR 2.29, 95% Cl 1.56-3.37) and less likely to attend a private hospital (OR 0.42, 95% Cl 0.30-0.60). Main constraints in the public health facility use were cost (25%), dissatisfaction with quality of care (19%) and transportation difficulties (12%). Costs were more likely to be a problem among rural (P=0.010), illiterate (P<0.001) and poor (P<0.001) while dissatisfaction with quality of care was associated with urban area (P<0.001) and poverty (P=0.001). Conclusion: Socio-demographic factors significantly drive the health seeking behaviours among general population. After adjusting for all factors, the poor were more likely to use public hospitals. Costs and dissatisfaction with quality of care were main constraints in utilization of the public health facilities.