Mahbubur Rahman, Md. Mofakharul Islam, Md. Rafiqul Islam, Gautam Sadhya, Md. Abdul Latif
Objective: The overall situation of health care system is poor in developing countries like Bangladesh due to inadequate access to modern health services and poor utilization. Aim of the study was to determine the health service seeking behaviour and factors associated with under-utilization of public healthcare facilities in rural areas of Bangladesh.
Methods: It was a community-based cross sectional study conducted among 492 systematically selected households having at least one child up to 1 year of age. Data were collected through face-to-face interview of the spouses of the household heads or any married women aged 15-49 years who could give information about the household.
Results: Educational status of the household heads and the respondents, monthly family income and standard of living were significant predictors for non-utilization of public healthcare facilities. Respondents pointed out poor quality of care and long waiting time as the main reasons for not taking services from public healthcare facilities. . Inconvenient service timing was the best predictor for not taking public health services for family planning (OR 1.67; p<0.05). Long waiting time was the best predictor for not using public health facility for immunization of children (OR 1.97; p<0.001). Short consultation time was identified as the best predictor for not using public health services for antenatal care (OR 1.74; p<0.005)), child delivery care (OR 2.00; p<0.005), postnatal care (OR 2.08; p<0.001) and for disease prevention and health education (OR 2.69; p<0.001). Absence of nearby public facility was the best predictor for not seeking self medical treatment from public health services (OR 1.29; p<0.005), which was followed by inconvenient service time (OR 1.74; p<0.05) and long waiting time (OR 1.69; p<0.05). Absence of nearby public health facility (OR 3.99; p<0.001) and long waiting time (OR 2.20; p<0.001) were the predictors for not seeking child medical treatment from public health services. Respondents who did not seek other family members’ treatment services from public health facilities were more likely to agree that there were no nearby public facility (OR 3.69; p<0.001), waiting time was too long (OR 1.89; p<0.005) and facility timing was inconvenient (OR 1.55; p<0.05). Short consultation time was the best predictor for not seeking child growth monitoring (OR 2.24; p<0.001) and health checkup services (OR 2.08; p<0.001) from public health care facilities.
Conclusion: Public health care facilities and overall medical services were under utilized and actions should be taken to improve the overall scenario of health system of rural Bangladesh.
