THE INFLUENCE OF WOMEN’S EARNING STATUS AND OTHER SOCIOECONOMIC FACTORS ON THEIR HEALTHCARE-SEEKING BEHAVIOR: EVIDENCE FROM THE BANGLADESH HOUSEHOLD INCOME AND EXPENDITURE SURVEY, 2016
DOI:
https://doi.org/10.24191/VoA.v21i1.11778Keywords:
Development, healthcare, healthcare-seeking behavior, women, BangladeshAbstract
human capital. The active participation of women who earn income plays a significant role in mitigating poverty and addressing gender disparities. Consequently, in the pursuit of fostering sustainable economic development, a comprehensive exploration of women's health concerns becomes imperative. The acquisition of accessible and qualified medical care stands as a vital component in preserving overall well-being. Regrettably, women residing in numerous underdeveloped nations often neglect this fundamental necessity. Improving healthcare-seeking behavior (HSB) is considered a vital strategy to optimize the utilization of healthcare services. However, women in the majority of developing countries demonstrate inadequate healthcare-seeking behavior (HSB). This study seeks to evaluate the influence of women's earning status and other socioeconomic factors on their HSB, using data from the Bangladesh Household Income and Expenditure Survey (HIES) 2016. Here we considered those women who were ill and sought any type of treatment during the 30 days of the survey. Based on Andersen’s behavioral model of health services use, this study employed a multinomial logistic regression model. The findings indicate that while women's educational attainment, urban residence, and chronic illness elevate the likelihood of seeking qualified healthcare providers, women who have income are more inclined to seek treatment from a pharmacy/traditional/self-care. These findings underscore the necessity for initiatives aimed at improving the HSB among women who have income and those residing in rural areas.
References
Adhikari, R. (2016). Effect of Women’s autonomy on maternal health service utilization in Nepal: a cross sectional study. BMC women's health, 16, 1-7.. https://doi.org/10.1186/s12905-016-0305-7
Ahmed, A. S., & Zaky, N. H. (2016). Health care-seeking behaviors among women suffering from urinary incontinence. J Nurs Care, 5(319), 2167-1168. https://doi.org/10.4172/2167-1168.1000319
Ahmed, M. S., & Yunus, F. M. (2020). Healthcare seeking behavior for common illness among Bangladeshi under-five children: a nationwide cross-sectional survey. Children and Youth Services Review, 119, 105644. https://doi.org/10.1016/j.childyouth.2020.105644
Ahmmed, F. (2022). Women's empowerment and practice of maternal healthcare facilities in Bangladesh: a trend analysis. Journal of Health Research, 36(6), 1104-1117. https://doi.org/10.1108/JHR-11-2020-0559
Amin, R., Shah, N. M., & Becker, S. (2010). Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis. International journal for equity in health, 9, 1-11. https://doi.org/10.1186/1475-9276-9-9
Andersen, R. (1968). A behavioral model of families’ use of health services ( Research Series No. 25). Chicago, IL: Center for Health Administration Studies, University of Chicago.
Andersen, R., & Newman, J. F. (1973). Societal and individual determinants of medical care utilization in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 95-124. https://doi.org/10.2307/3349613
Ausserhofer, D., Wiedermann, W., Becker, U., Vögele, A., Piccoliori, G., Wiedermann, C. J., & Engl, A. (2022). Health information-seeking behavior associated with linguistic group membership: latent class analysis of a population-based cross-sectional survey in Italy, August to September 2014. Archives of Public Health, 80(1), 87. https://doi.org/10.1186/s13690-022-00847-w
BBS. (2017). PRELIMINARY REPORT ON HOUSEHOLD INCOME AND EXPENDITURE SURVEY 2016. Bangladesh Bureau of Statistics (BBS), Statistics and Informatics Division (SID), Ministry of Planning, Government of the People’s Republic of Bangladesh. file:///C:/Users/ASUS/Downloads/hies_preliminary_report_2016%20(1).pdf
Bhuiya, A., Shaila Mahmood, S., Rana, A. K. M. M., Wahed, T., Ahmed, S. M., & Chowdhury, A. M. R. (2007). A Multidimensional Approach to Measure Poverty in Rural Bangladesh. Journal of Health, Population, and Nutrition, 25(2), 134–145.
Bloom, D. E., Kuhn, M., & Prettner, K. (2019). Health and Economic Growth. Oxford Research Encyclopedia of Economics and Finance. Oxford University Press. https://doi.org/10.1093/acrefore/9780190625979.013.36
Bloom, D. E., Kuhn, M., & Prettner, K. (2020). The contribution of female health to economic development. The Economic Journal, 130(630), 1650–1677. https://doi.org/10.1093/ej/ueaa061
Bustreo, F., Knaul, F. M., Bhadelia, A., Beard, J., & Carvalho, I. A. D. (2012). Women's health beyond reproduction: meeting the challenges. Bulletin of the World Health Organization, 90, 478-478A. https://doi.org/10.2471/BLT.12.103549
Chen, L., Fan, H., & Chu, L. (2020). The double-burden effect: Does the combination of informal care and work cause adverse health outcomes among females in China?. Journal of Aging and Health, 32(9), 1222-1232.
Du, L., Xu, B., Huang, C., Zhu, L., & He, N. (2020). Menopausal symptoms and perimenopausal healthcare-seeking behavior in women aged 40–60 years: a community-based cross-sectional survey in Shanghai, China. International journal of environmental research and public health, 17(8), 2640.. https://doi.org/10.3390/ijerph17082640
Escamilla, V., Calhoun, L., Winston, J., & Speizer, I. S. (2018). The role of distance and quality on facility selection for maternal and child health services in urban Kenya. Journal of Urban Health, 95, 1-12. https://doi.org/10.1007/s11524-017-0212-8
FAO. (2017, October 23). Women empowerment is key to fighting hunger and poverty. Food and Agriculture Organization of the United Nations. Retrieved from http://www.fao.org/africa/news/detail-news/en/c/1051443/
Faiz, A., & Basher, A. (2011). Antimicrobial resistance: Bangladesh experience. World Health Forum 15(1)
Gabrani, J., Schindler, C., & Wyss, K. (2021). Health seeking behavior among adults and elderly with chronic health condition (s) in Albania. Frontiers in public health, 9, 616014. https://doi.org/10.3389/fpubh.2021.616014
Gu, R., & Nie, F. (2021). Does empowering women benefit poverty reduction? Evidence from a multi-component program in the Inner Mongolia Autonomous Region of China. Journal of Integrative Agriculture, 20(4), 1092–1106. https://doi.org/10.1016/S2095-3119(20)63436-0
Habtu, Y., Yohannes, S., & Laelago, T. (2018). Health seeking behavior and its determinants for cervical cancer among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: community based cross sectional study. BMC cancer, 18, 1-9. https://doi.org/10.1186/s12885-018-4203-2
Haider, M. R., Qureshi, Z. P., & Khan, M. M. (2017). Effects of women’s autonomy on maternal healthcare utilization in Bangladesh: Evidence from a national survey. Sexual & Reproductive Healthcare, 14, 40–47. https://doi.org/10.1016/j.srhc.2017.09.002
Hamiduzzaman, M., De Bellis, A., Abigail, W., Harrington, A., & Fletcher, A. (2023). “When I suffer from fever, I eat mangos.” Determinants of health-seeking beliefs and behaviors of rural older women in Sylhet, Bangladesh. Journal of Women & Aging, 35(1), 4–21. https://doi.org/10.1080/08952841.2021.1996195
Hasan, M. N., & Uddin, M. S. G. (2016). Women empowerment through health seeking behavior in Bangladesh: Evidence from a national survey. South East Asia Journal of Public Health, 6(1), 40–45. https://doi.org/10.3329/seajph.v6i1.30343
Hasan, M. T., Amin, A., Chowdhury, M. U., Faizul Islam, K., Huq, S. M., Parvin, R., Ahmed, S. J., Ali, M. L., & Rashid, S. F. (2021). Health sufferings, healthcare seeking behavior, awareness about health insurance, and health related rights of ready made garments workers in Bangladesh: Findings from a cross‐sectional study. Journal of Occupational Health, 63(1), e12256. https://doi.org/10.1002/1348-9585.12256
Hausman, J., & McFadden, D. (1984). Specification Tests for the Multinomial Logit Model. Econometrica: The Econometric Society, 52(5), 1219-1240. https://doi.org/10.2307/1910997
Hossain, D. (2020). Socioeconomic Status and Maternal Health-seeking Behavior: A Comparative Study between a Rural Site and an Urban Community in Bangladesh. Journal of International Women’s Studies, 21(6), 122-134.
Kassim, M. (2021). A qualitative study of the maternal health information‐seeking behaviour of women of reproductive age in Mpwapwa district, Tanzania. Health Information & Libraries Journal, 38(3), 182–193. https://doi.org/10.1111/hir.12329
Khan, M. S. I., Ani, J. F., Rani, B., Apon, S. J., Rashid, F., Yead, T. I., ... & Chowdhury, S. (2018). Healthcare-seeking behavior for infectious diseases in a community in Bangladesh. International Journal of Advanced Medical and Health Research, 5(2), 52-56. https://doi.org/10.4103/IJAMR.IJAMR_38_18
Khanam, M., & Hasan, E. (2020). Inequalities in health care utilization for common illnesses among under five children in Bangladesh. BMC pediatrics, 20, 1-11. https://doi.org/10.1186/s12887-020-02109-6
Kifle, D., Azale, T., Gelaw, Y. A., & Melsew, Y. A. (2017). Maternal health care service seeking behaviors and associated factors among women in rural Haramaya District, Eastern Ethiopia: a triangulated community-based cross-sectional study. Reproductive health, 14, 1-11. https://doi.org/10.1186/s12978-016-0270-5
Kruk, M. E., Gage, A. D., Joseph, N. T., Danaei, G., García-Saisó, S., & Salomon, J. A. (2018). Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. The Lancet, 392(10160), 2203-2212.
Langer, A., Meleis, A., Knaul, F. M., Atun, R., Aran, M., Arreola-Ornelas, H., ... & Frenk, J. (2015). Women and health: the key for sustainable development. The Lancet, 386(9999), 1165-1210.
Liu, G., Xue, Y., Qian, Z., Yang, L., Yang, Y., Geng, Q., & Wang, X. (2019). Healthcare-seeking behavior among pregnant women in the Chinese hierarchical medical system: a cross-sectional study. International Journal for Equity in Health, 18, 1-8. https://doi.org/10.1186/s12939-019-1037-8
Lo, T. K. T., Parkinson, L., Cunich, M., & Byles, J. (2016). Factors associated with the health care cost in older Australian women with arthritis: An application of the Andersen’s Behavioural Model of Health Services Use. Public Health, 134, 64–71. https://doi.org/10.1016/j.puhe.2015.11.018
Long, J. S., & Freese, J. (2014). Regression models for categorical dependent variables using Stata (3rd ed.). College Station, TX: Stata Press.
Lopes Ibanez-Gonzalez, D., Mendenhall, E., & Norris, S. A. (2014). A mixed methods exploration of patterns of healthcare utilization of urban women with non-communicable disease in South Africa. BMC health services research, 14, 1-9. https://doi.org/10.1186/s12913-014-0528-y
Mahmood, S. S., Iqbal, M., Hanifi, S. M. A., Wahed, T., & Bhuiya, A. (2010). Are 'Village Doctors' in Bangladesh a curse or a blessing?. BMC international health and human rights, 10, 1-10. https://doi.org/10.1186/1472-698X-10-18
Mainuddin, A. K. M., Begum, H. A., Rawal, L. B., Islam, A., & Islam, S. S. (2015). Women empowerment and its relation with health seeking behavior in Bangladesh. Journal of family & reproductive health, 9(2), 65-73.
Maligalig, R., Demont, M., Umberger, W. J., & Peralta, A. (2019). Off-farm employment increases women’s empowerment: Evidence from rice farms in the Philippines. Journal of Rural Studies, 71, 62–72. https://doi.org/10.1016/j.jrurstud.2019.09.002
Masiye, F., & Kaonga, O. (2016). Determinants of Healthcare Utilisation and Out-of-Pocket Payments in the Context of Free Public Primary Healthcare in Zambia. International Journal of Health Policy and Management, 5(12), 693–703. https://doi.org/10.15171/ijhpm.2016.65
Matsumura, M., & Gubhaju, B. B. (2001). Women’s status, household structure and the utilization of maternal health services in Nepal. Asia-Pacific Population Journal, 16(1), 23–44. https://doi.org/10.18356/e8a4c9ed-en
Meng, H., Liao, Q., Suen, L. K. P., O’Donoghue, M., Wong, C. M., & Yang, L. (2016). Healthcare seeking behavior of patients with influenza like illness: comparison of the summer and winter influenza epidemics. BMC infectious diseases, 16, 1-9.
Nahar, P., Unicomb, L., Lucas, P. J., Uddin, M. R., Islam, M. A., Nizame, F. A., Khisa, N., Akter, S. M. S., & Rousham, E. K. (2020). What contributes to inappropriate antibiotic dispensing among qualified and unqualified healthcare providers in Bangladesh? A qualitative study. BMC Health Services Research, 20, 1-11. https://doi.org/10.1186/s12913-020-05512-y
Pajuelo, M. J., Anticona Huaynate, C., Correa, M., Mayta Malpartida, H., Ramal Asayag, C., Seminario, J. R., ... & Paz-Soldan, V. A. (2018). Delays in seeking and receiving health care services for pneumonia in children under five in the Peruvian Amazon: a mixed-methods study on caregivers’ perceptions. BMC health services research, 18, 1-11. https://doi.org/10.1186/s12913-018-2950-z
Panchani, M. (2014). Role of primary health care in the empowerment of women and concern about health issues. Int J Res Stud Biosci (IJRSB), 2, 21-7.
Paudel, D. R. (2019). Factors Affecting Health Care Expenditure in the First Piloted Government Health Insurance Program District of Nepal. Journal of Management and Development Studies, 29, 45–60.
Pulla, P. (2016). Are India’s quacks the answer to its shortage of doctors? BMJ, i291. https://doi.org/10.1136/bmj.i291
Rasul, F. B., Kalmus, O., Sarker, M., Adib, H. I., Hossain, M. S., Hasan, M. Z., ... & De Allegri, M. (2019). Determinants of health seeking behavior for chronic non-communicable diseases and related out-of-pocket expenditure: results from a cross-sectional survey in northern Bangladesh. Journal of Health, Population and Nutrition, 38, 1-14. https://doi.org/10.1186/s41043-019-0195-z
Reddy, P. M. C., Rineetha, T., Sreeharshika, D., & Jothula, K. Y. (2020). Health care seeking behaviour among rural women in Telangana: A cross sectional study. Journal of Family Medicine and Primary Care, 9(9), 4778-4783. https://doi.org/10.4103/jfmpc.jfmpc_489_20
Müller, A. P. R., Lerusse, A., Steen, T., & Van de Walle, S. (2021). Understanding channel choice in users' reporting behavior: Evidence from a smart mobility case. Government Information Quarterly, 38(1), 101540. https://doi.org/10.1016/j.giq.2020.101540
Schreiber Pedersen, L., Lose, G., Høybye, M. T., Jürgensen, M., Waldmann, A., & Rudnicki, M. (2018). Predictors and reasons for help-seeking behavior among women with urinary incontinence. International Urogynecology Journal, 29(4), 521–530. https://doi.org/10.1007/s00192-017-3434-0
Shrestha, M. V., Paudel, L., Pant, S., Neupane, S., & Manandhar, N. (2017). Health seeking behavior among women in Bhimtar, Sindhupalchowk district of Nepal. International Journal Of Community Medicine And Public Health, 4(6), 1854-7. https://doi.org/10.18203/2394-6040.ijcmph20172144
SIAPS. (2015). Baseline Study of Private Drug Shops in Bangladesh: Findings and Recommendations. the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arlington, VA: Management Sciences for Health. http://siapsprogram.org/wp-content/uploads/2015/12/15-226-SIAPS-BD-Study_final-Revised-Report_10-Sept.-2015.-FINAL.pdf
Slobbe, L. C. J., Wong, A., Verheij, R. A., van Oers, H. A. M., & Polder, J. J. (2017). Determinants of first-time utilization of long-term care services in the Netherlands: An observational record linkage study. BMC Health Services Research, 17, 1-10. https://doi.org/10.1186/s12913-017-2570-z
Sreeramareddy, C. T., Sathyanarayana, T. N., & Kumar, H. H. (2012). Utilization of health care services for childhood morbidity and associated factors in India: a national cross-sectional household survey. PLoS one, 7(12), e51904.
Tahsina, T. (2017). Out-of-pocket expenditure for seeking health care for sick children younger than 5 years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012. Population and Nutrition, 36, 1-9.
Uddin, J., & Mazur, R. E. (2015). Socioeconomic factors differentiating healthcare utilization of cyclone survivors in rural Bangladesh: A case study of cyclone Sidr. Health Policy and Planning, 30(6), 782–790. https://doi.org/10.1093/heapol/czu057
Untari, J., & Nugroho, A. (2019). Qualitative Study of Family Support for Women’s Health Seeking-Behaviour in Rural Areas District Sleman. Indonesian Nursing Journal Of Education And Clinic (INJEC), 4(1), 70-78.
UN Women (Ed.). (2020). Why addressing women’s income and time poverty matters for sustainable development. United Nations.
Wado, Y. D. (2018). Women’s autonomy and reproductive health-care-seeking behavior in Ethiopia. Women & Health, 58(7), 729–743. https://doi.org/10.1080/03630242.2017.1353573
Wang, Q., Fu, A. Z., Brenner, S., Kalmus, O., Banda, H. T., & De Allegri, M. (2015). Out-of-pocket expenditure on chronic non-communicable diseases in sub-Saharan Africa: the case of rural Malawi. PloS one, 10(1), e0116897.. https://doi.org/10.1371/journal.pone.0116897
Ward, H., Mertens, T. E., & Thomas, C. (1997). Health Seeking Behaviour and the Control of Sexually Transmitted Disease. Health Policy and Planning, 12(1), 19–28. https://doi.org/10.1093/heapol/12.1.19
Wellay, T., Gebreslassie, M., Mesele, M., Gebretinsae, H., Ayele, B., Tewelde, A., & Zewedie, Y. (2018). Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia. BMC health services research, 18, 1-9. https://doi.org/10.1186/s12913-018-3490-2
WOW. (2020). The Double Day: Exploring unpaid work and care for female garment workers in Bangladesh. The Work and Opportunities for Women (WOW) Programme in partnership with Primark , UK aid. https://assets.publishing.service.gov.uk/media/5f1850563a6f407271c70c11/The-Double-Day-WOW-Primark-Unpaid-Work-Care-Report-July2020a.pdf
Yanikkerem, E., Ay, S., & Piro, N. (2013). Planned and unplanned pregnancy: effects on health practice and depression during pregnancy. Journal of Obstetrics and Gynaecology Research, 39(1), 180-187. https://doi.org/10.1111/j.1447-0756.2012.01958.x
Yaya, S., Bishwajit, G., Ekholuenetale, M., & Shah, V. (2017). Awareness and utilization of community clinic services among women in rural areas in Bangladesh: a cross-sectional study. PloS one, 12(10), e0187303. https://doi.org/10.1371/journal.pone.0187303
Yeoh, P. L., Hornetz, K., & Dahlui, M. (2016). Antenatal care utilisation and content between low-risk and high-risk pregnant women. PLoS One, 11(3), e0152167. https://doi.org/10.1371/journal.pone.0152167
Zhang, Q., Feng, S., Wong, I. O., Ip, D. K., Cowling, B. J., & Lau, E. H. (2020). A population-based study on healthcare-seeking behaviour of persons with symptoms of respiratory and gastrointestinal-related infections in Hong Kong. BMC Public Health, 20, 1-10. https://doi.org/10.1186/s12889-020-08555-2
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
