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Understanding illness prevalence and health seeking behavior among Pakistani people

By :Asmita Sohani

Since the formation of Pakistan from 1947, it has progressed in many aspects. The ministries of health of Pakistan and private sectors along with world Health Organization have given their efforts in reducing the prevalence and occurrence of diseases and health issues. However much effort needs to take place at primary level. Moreover it is also the responsibility of people of Pakistan to seek medical help whenever required. Such behavior of seeking medical help and attention on time is known as health seeking behaviors. If appropriate medical attention is received on time, much of the burden of disease on Pakistan can be reduced. Though delay in seeking medical help at primary stage of the disease can lead to serious health complications. According to Mohan, Lyengar, Martines, Cousens and Sen (2004), “Delays in seeking appropriate care and not seeking care at all, contribute to the large number of child’s death in developing countries”. On the other hand there are several hindrances in receiving medical aid on time. In this article I will discuss the barriers to health seeking in Pakistan, the impact of such barriers on the economy and health status of people and strategies to overcome such hindrances.

There are several socio-cultural and psychological obstacles towards seeking help in Pakistan. One of the major socio-cultural factors includes gender role. According to Howerton, Byng, Campbell, Hess, Owens, Aitken (2007), “men are among those people least likely to seek help from health care professionals, even when experiencing severe level of distress” (Introduction, para. 1). Therefore male members of the society compel from receiving medical care due to cultural expectations as being tough and independent. Other socio-cultural causes are lack of trust on health care professionals due to belief on spiritual and faith healers, family influences, strict pardha system and low socioeconomic status. As stated by Muynck and Ali (2005) “. “Participants generally believed that illness was mainly due to evil spirit and spiritual healers were thought to posses the right knowledge” (p. 528). Social stigma plays a crucial role in taking medical care. For example some type of communicable disease such as HIV/AIDS or chronic illness such as breast cancer would all result in less access to health facility. On the other hand some psychological factors might include lack of awareness about warning signs of disease, fear of disrespectfulness from healthcare providers, fear of diagnosed as having chronic disease. Moreover long waiting hours and lack of access to adequate medical facility also contributes to delay health seeking.

Delay in health seeking greatly affects the economy and health of a country. As mentioned previously diseases if not treated at primary stages can lead to serious health consequences. As a result a country faces great burden of diseases. The total expenditure on health per capita in year 2005 is 48 (World Health Organizations, 2007). Currently half of the population of Pakistan is children and “most persistent health burdens in Pakistan affect women and children” (Community Health Sciences, Aga Khan University, 2001). Therefore the infant mortality rate in Pakistan during year 2004 was 80 million (Hussain, 2005). Consequently people fearing of loosing money in the treatment of disease at early stage might have to give large amount of money for treatment at later stages of disease. On the other hand, people of Pakistan have a perception of health as “a state allowing them to work and earn money and health is a prerequisite for work and is instrumental to survival” (Muynck & Ali, 2005). As a result of unhealthy conditions, people are not able to work and earn money for their families consequently leading towards poverty. Similarly the economy of the country is also affected.

Therefore strategies to overcome these hindrances need to be implemented at community and governmental level. At community level the smallest unit of society i.e. family can be addressed. As family cohesion influences greatly on individual health seeking behaviors and decision making therefore family centered interventions need to be carried out. “Children learn their parent’s attitudes, beliefs and values through direct teaching and observation” (Cardol, Groenewegen, Bakker, Spreeuwenberg, Dijk & Bosch, 2005). Thus family focused interventions may include spreading awareness on maternal and child health, illness in older adults and importance of seeking medical attention on time. Moreover media can play a vital role in enhancing health knowledge in people through displaying public education advertisements on television, newspaper and magazines. At governmental level, the ministry of health and other private sectors need to focus on low socioeconomic status people. “Providing the necessary preventive and curative services by integrating services of both public and private sectors in reaching the undeserved segments of the population” (Muynck and Ali, 2005, p. 531). In addition government should ensure that health care centers are accessible to people and that these facilities are utilized effectively. Moreover health issues and medical knowledge can be incorporated in the secular curriculum of school to enhance their health knowledge from the very beginning.

Thus by understanding the barriers to health seeking and by implementing strategies, its impact on economical and health status can be reduced. According to World Health Organization, in year 2005, 96% of the total population had access to local health care services. However how many people have used those services effectively is still unanswerable. Therefore in conclusion research studies should be done in Pakistan in different cultural and areas to identify obstacles to use of health care facility. Such researches would aid government and private sectors to identify factors in different cultures and try to work on it to prevent disease occurrence and prevalence. Finally health care professionals need to improve their communication skills in order to increase family’s readiness to seek care. These communication characteristics would include attentive listening, dealing in compassionate manner, treating with respect and providing knowledge about disease.