You are on page 1of 21

HEALTH-SEEKING BEHAVIOR AND ACCESS TO HEALTH CARE FACILITIES

AMONG RURAL RESIDENTS IN LOWER BUSAY, CEBU CITY

______________________________________________________________________
A Research Paper Presented to the
Faculty of the College of Nursing
Cebu Doctors’ University
Mandaue City
______________________________________________________________________
In Partial Fulfillment of the Course
Requirements of the Degree
Bachelor of Science
In Nursing
______________________________________________________________________
By:

Jan Patrick C. Go

Danise Britchelle C. Ngujo

Xaviera A. Galang

Jason Arnold T. Pepito

Gleziel Ann Marie F. Inot

Jaisa Cristel T. Ramayla

John Brian S. Leguera

Antonette Kaye M. Santos

Angela G. Perez, M.A.N.
Research Mentor
February 23, 2016

Chapter 1
THE PROBLEM AND ITS SCOPE
THEORETICAL FRAMEWORK
Rationale
Each one of us is unique when it comes to seeking things related to our health,
we all have different perspectives, beliefs, traditions and our behavior towards it may
vary. Many things may vary like the accessibility of the health care facilities, educational
background, social and economic status, the distance of facilities, also the severity of
health condition.

Appropriate health seeking behavior is important to lessen complications and
improve the quality of life, but a number of factors has been identified as the causes of
low health care services utilization this includes the following: below average socioeconomic status, lack of physical capacity, traditions, perceptions, superstitions and
cultural beliefs also the educational attainment of mothers.

Our study mainly focus on rural residents in Lower Busay, Cebu City among
these types of people superstition beliefs and cultural practices often lead to selftreatment, home-made remedies are being made, herbal treatment are being utilized
and even consultation with local faith healers. Health teachings from these traditional
healers are very instrumental and cannot be ignored, thus causing delay in treatment
seeking.

and rural nurses which have sicker patients who often need emergency care. 2004) Found that the personality of the rural residence of self-reliance and independence might cause the individual to delay seeking health care. were often factors that affected rural . according to one of the residents from the area he explained that during emergency cases whether its dusk or dawn they have to travel up to the highway. illness behavior is an individual’s way or action as to how he/she is going to take remedial measures for his/her own health condition (Trekas 58) (Mason. isolation and remote distances. Thus. the researchers aim to determine how the variable of health seeking behavior is influenced by the location or the distance of the respondents from the source of care given in the local community clinic. There issues could be more acute and critical. This state is what we call Illness behavior. Theoretical Background In this study. We all have in us the attribute in which we behave in a particular manner as to how we are to manage the alteration in our physical health. endeavor such narrow path way or steep crevices and terrains just to call for help from heath care workers thus causing further complications to the individual at risk. This can put an additional burden on rural hospitals. The lack of transportation.In relation to their access and utilization to health care facilities these people are situated in an area far away from their health care provider.

then such ill individual would remain ill.individuals from seeking regular health care. But on the other side. Sources of treatment may be available but if there is difficulty or no chance at all of getting that aid. attitude and skills. This shows that the behavior of the ill individual in going to a health facility is of importance as well. her theories includes facilitating for the promotion of health and prevention of diseases. Faye Abdellah brings into light the role of an effective care provider to be possible only when there is right knowledge. Their study also revealed that rural individuals may be hesitant to travel long distances and might have a lack of trust of specialist that might be needed for their care and would more often chose a rural provider that they were familiar with. the only way to arrive at a more maneuverable pathway is for the sick person to be carried not by just one person but by making a hammock and using bamboo pole to carry the sick. In cases wherein road is steep or narrow. This means that a health care provider does not act only during an ill person is present . Such way needs the volition of the sick to sit on the hammock while the persons carrying the hammock need to have strong will to endeavor such narrow path way or steep crevices. Volition also does not necessarily comes only from the sick person but also from the norms. David Mechanic in his “The concept of illness behavior” (1962) points out the importance of effecting the arrival of ill person at the medical setting in order for treatment to be effectively administered. values and fears of those around the individual.

In this study. And their growth in population and decrease in sickness signals that the behavior they have is somehow effective in order to achieve optimum health. an ill person would have difficulty already of travelling to the nearest care provider. the researchers aim also to determine how the residents are able to overcome the barriers or difficulty they experience just to avail of treatment or preventive management from their nearest clinic. . defines human caring in nursing as a “human-tohuman process through therapeutic interpersonal interactions. The theory of Abdellah is one that is relevant in bringing up how the behavior of the residents are in order to remain healthy by prevention. or for residents to bring their pets for immunization against rabies. Among such behaviors are if they are willing to wake up early and walk the narrow pathway in order to ensure that their babies get vaccinated.but also prior to it. Jean Harman Watson (1979). or for pregnant women to walk slowly for hours till they are able to reach the clinic for prenatal. For the study of the researchers. Therefore it’s good also to view the behavior of the residents on how they are willing to prevent getting sick. It is not easy for the residents but present census shows that their population is still increasing thus signaling that they are able to survive or multiply.

socioeconomic status. such as age. How people behave and cope when they are ill varies and is affected by many variables.. (Taylor. al. 2001) . occupation. Because independence and self-sufficiency are important to adolescents and adults. their occurrence can lead to delayed development. Illness behaviors are the actions and management a person would do to know his or her condition so he or she can get appropriate intervention. loss of independence. Sociologists refer this as Illness Behavior. even religion (Kozier et al. If hospitalized. et. he or she may behave in certain ways to cope up with the certain health problem. they will not easily accept the “dependent sick’ role. sex. and permanent changes in personal and career goals.Review of Related Literature Illness behavior When a person become ill. Although chronic illness is less common. education. Acute Illness is often more of an annoyance than of serious consequence. an adolescent’s and adults motivation to recover and to resume normal activities is strong. traditions and cultural beliefs. 2004).

the availability of the transportation for them to reach their health care provider. environmental and climatic barriers. We have so many ways of taking care of our health depending on our own beliefs. people need to travel greater distances just to have access to health care services and get a consultation with their health care provider. rural residents may have limitations in accessing health care services. In rural places. The aim of prolonging our lives is important that is why people are continuously looking and finding for ways for the betterment of their health. One factor may be because of the geographical area. People may have different health-seeking behaviors depending on a lot of factors. due to geographic distance. Often. Healthcare Access in Rural Communities According to Healthy People 2020. . People living in far-off places like the ones in the rural area are most probably experiencing not being able to gain access to health care facilities and the services being offered. The following are barriers rural residents experience in relation to their access to health care services and utilization: a health care facility located far away from their homes. rural residents are often experiencing barriers in accessing healthcare services and in return limit their ability to get the care they need. cultures and traditions.Health Seeking Behavior Taking care of our health is really a vital and essential part of our lives. financial constraints and also their ability to communicate about their health problems and complaints to their health care provider. challenging roads.

thus the ability to get the care that they deserve will now have a limitation. the population need to navigate greater distances to access different locations of the health care delivery system.There a lot of factors which play a vital role in accessing the healthcare services it involves.Rural residents usually experiences some barricade to health care services available in the near area. finite education is attained. mode of transportation. In order for the residents in rural areas to have a satisfactory health care access.In rural areas. The educational attainment of the resident will also exposed them for low health literacy because of lower educational attainment since a lot of people living in rural area are suffering from poverty as a result.distance from the heath care services and other financial measures. the accessibility of the health care services must be feasible as evidenced by readily available health care services that can be attain in a timely manner. . It is found out that elderly residents who have a persistent illness or condition that requires an annual intervention requires numerous visits to outpatient health care services and thus will involve dependable mode of transportation.Rural population will have a limited access to health care services as a result of inadeaquate public transportation and challenges that residents usually are facing in the road. The uncommon geographic placement tend to develop difficulty of the residents in rural areas to travel lengthy distances in order to access their respective healthcare services. The accessibility of the health care services would also depend on the age of the individual living in the particular area.

. and nearby health clinics and other medical institutions are readily available.Rural residents often face a pile of burdens regarding transportation to health care services due to its unique geographic distance.Urban areas often has an access to medical services since they don’t have a problem when it comes to traveling distance. .There is also a national realization that residents in rural areas are facing barriers to wellness and health compared to those faced by residents in urban areas.

Boynton.” Final results revealed that the majority of participants (84%). only 28% had received such services in the past month. availability of health services and affordability to meet the cost for health services in Australia. The reason of the study is to “Assess the health seeking practices and challenges in utilizing health facilities in a rural community in Uganda. . and M. The participants' health seeking behavior the last time they were sick was associated with age (p = 0.009). The most significant challenges in utilizing health services were regular stock-out of drugs. Musoke. While 89% knows that mobile clinics existed in their community. P.Supporting Studies A study entitled "Access to Health Care Services in An Australian Rural Area". B. Another study entitled "Health Seeking Behavior and Challenges in Utilizing Health Facilities in Wakiso District. in their community. C. This study focuses on investigating access to health care facilities by considering access limits such as accessibility for transportation. payment for services and absence of emergency services . Butler.028) and occupation (p = 0. Uganda" by D. This study showed that their rural residents are having difficulty in accessing health care facilities which calls for immediate corrective actions. Final conclusion was by increasing the frequency of mobile clinics and strengthen the community health worker’s strategy we can be able to potentially increase access to health care facilities in the rural area. did not know that community health workers existed. Musoke (2014). high cost of services and long distance to health facilities. Some participant were satisfied with the health care service some were not because of concerns like difficulty to access transport.

Van de Poel. Barbara McPake (2014) on the “Access to health care: taking into account health systems complexity”. Bedi (2014). Their study is to inquire the basis of healthcare-seeking behavior. Mebratie. Alemu. continuums of skill and time required in the provision of care. hindered by numerous impediments. they seek medical care compared to those in poorer household. and A. According to the study of Dina Balabanova. as a result. Z. non-linear relationships. They stated in their study. Abebaw. S. The residents in poorer household usually postpone their seeking of medical . Previous theoretical frameworks often describe access to be a one-stop contact with the health system. Another study entitled "Healthcare-seeking Behavior in Rural Ethiopia" by A.Several studies has already been conducted to further widen the knowledge in people’s way of accessing health care in variations of situation in different communities especially the rural ones. where to seek modern care. which focuses on the understanding of the how people who have low and middle income access care. D.Justin Parkhurst. E. The study combines and utilizes different findings from various kinds of studies regarding the utilizer and the provider’s different practices and beliefs. Those existing theoretical frameworks was not able to contend with the complexities included in accessing the different health services. Martin Mckee. G. whether to seek modern care. that “There is a relationship between socioeconomic status and choice providers mainly for adult-related conditions with households who can afford. Their study deals with three issues: when to seek modern care. Yilma. the communities’ role in interposing the access of the members and the dynamic way of providers and patients in interacting. D.

5% for the age of the resident and 5% for the household position. Reducing the payment for medical care introduces an important role in improving the access to a health care facility especially to those who belong to the poor household. These are the following: the type of illness experienced by the resident. 20% for the money available at that time. This study is focuses on the reasons how the rural residents in the area seek medical services. household position and religion. Among the factors involved. age.care but for the both households they both act faster when its already child-related condition. Since the rural residents are isolated from the health care facilities. The outcome of the study showed that there are factors affecting the way they seek medical service. this study proposes that the rural areas should be provided with health care facilities that they can easily access. service available. There should also be a complete equipment and providing more medical staff available in the health care facility to provide better care to the rural residents. how severe the illness is. The researchers concluded that the inability of healthcare utilization is not directed by the unable to recognize health problems or due to a low recognized need for modern care. 42% is the type of illness. Another study entitled "Health Seeking Behaviour among the Rural Dwellers in Ekiti State. educational background. the money available at that time. Nigeria" by Oluwatuyi O. . (2010).

4 highest educational attainment 1.2 Hospitals 3. What is the profile of respondents according to: 1.8 Family demographics 2.3 Doctor’s clinic 3. From the findings what output could be formulated based on the results of the study? . the study aims at answering the following: 1.1 Health Center 3.THE PROBLEM Statement of the Problem This study aims to assess the level of compliance in the utilization of health care facilities in relationship to the distance between the infrastructure and the people who needs care among residents living in Lower Busay. Determine the behavior of respondents towards health seeking 3. Is there a significant relationship between health-seeking behavior and access to health care facilities? 5.7 Distance from nearest health care facility 1. Cebu City Specifically.3 civil status 1. Determine the respondents access to health care facilities 3.2 gender 1.1 age 1.4 Hospices 4.6 number of years residing 1.5 family income 1.

They are presented with the real challenge in promoting the interest of the residents through the promotion of health by coordinating with barangay health officials in terms of lifesaving services. The study is significant to the following: Community Residents. Researchers. Knowing and assessing the behaviors regarding the health of the population I relation to the distance between health care facilities and the residents of Lower Busay. Cebu City would have a profound impact in ensuring an environment that is conducive.Significance of this study The importance of behavior towards health and access to health care services should be given emphasis and not be taken for granted. It serves as an information about the importance of accessible health care facilities and health-seeking behavior acted by the respondents. It is important to perform their duties and responsibilities through enforcement of the maintenance and operation of facilities in health promotion. The community residents will readily approach the health care facilities available in their area in that will provide them health education in the promotion of health and prevention of illnesses Barangay Officials. It will serve as an enlightenment and awareness for them to know the availability of health care facilities. Distance may have an effect on how the . It provides additional background and knowledge regarding the significance of distance between the residents' homes and an available health care facility is a vital factor in the development of a health seeking behaviour.

Cebu City. Future Researchers. This study was conducted in Lower Busay. The success of the study was highly dependent on the data provided by the respondents. either the residents travel to a health care center or perform home remedies.residents of Lower Busay attain good health. Cebu City Limitations: The study was limited to only the population who resides in Lower Busay. The sincerity and honesty in answering the questions would also affect the results . Cebu City. Rural residents who have been residing in the area for almost 10years. It serves as an added reference if they make researches similar in nature. Scope and Limitation Scope: The scope of this study focused on the correlation between access to health care facilities and the developed health-seeking behavior of the residents of Lower Busay.

Research Respondents The respondents of the study will be the residents of Lower Busay. Cebu City this place is suitable for our study since the residents living in this area are situated in a place with no proper roads. Cebu City. Inclusion Criteria: a) that they reside in Lower Busay. and d) the residents will be able to understand simple English Exclusion Criteria: Those who do not fit the criteria mentioned above .RESEARCH METHODOLOGY Research Design The study utilized Descriptive-Correlational research design to identify the correlation between health-seeking behavior and access to health care facilities among rural residents in Lower Busay. c) the participants of the study will be 18 years old and above.Seeking Behaviors of the residents. almost 5km away from the nearest health center. The survey will collect quantitative data that will be taken using random sampling on the range of different Health. b) that they are willing to cooperate and participate in the study. far from the main highway. there will be 129 residents that will be taken as part of the study. downhill and terrain. Cebu City Research Environment The study was conducted in Lower Busay.

This study will be using a questionnaire with both open and closed questions. .Scale of the General Status and Illness Behavior Questionnaire by Issy Pilowsky and Neil Spence Chinese Citizen Health Literacy Questionnaire includes four dimensions (belief literacy. Closed questions will have preceded answers such that it can be answerable by a simple yes or no and will allow for the researchers to focus in aiming for the respondents to come up with answers particularly emphasized for the said study to be done.904. indicating high reliability and good content validity. are the rural residents of Busay.Research Instruments The researchers will be modifying a particular questionnaire from the internet by another author to be able to gather data for the study chosen. The primary aim of the questionnaire is to be able to find out the people's behavior in terms of seeking for health care and their access to the health care facilities that are available in their area. 2008) . Cebu City. Open questions will be answered accordingly by the respondents as to their extent with any open comments. knowledge literacy and skill literacy) the questionnaire has a Cronbach α coefficient of 0. behavior literacy. This people specifically. The said questionnaire will be used by the researchers in the process of gathering the data necessary: The three research tool that will be utilized in this study will be the Chinese Citizen Health Literacy Questionnaire (China Health Education Centre.

. Illness Behavior Questionnaire by Issy Pilowsky and Neil Spence that measures the ways individuals experience and respond to their health status Procedures for Gathering Data DATA GATHERING The researchers will set schedule with the barangay captains and will go to the locale with the permission of the research coordinator and research mentor. introduce themselves and orient the study about their own health seeking behavior and their access to their health care facilities to be conducted at their respective houses since we will be doing home visits. health status. including health-related behaviors. The collection of the answered questionnaires will be followed for tabulation. analysis and interpretation. At each house. they will introduce themselves to the family and orient those who will take part of the study. The respondents who will agree and sign the informed consent will be given a maximum of 1 hour to answer the questionnaire. and sociodemographic characteristics. For the residents.Scale of the General Status The survey instrument adapted standardized and validated questions across several domains. For the first group of respondents. the researchers will approach kindly. the researchers will go from house to house in different sitios in the different barangays until the sample size will be met. Clear instructions will be given to guide the respondents. through random sampling.

The researchers will submit a manuscript to the ethics committee. They will send a transmittal letter to the barangay captains of the selected barangay to request for the updated population of adults in their barangay ages 18 years old and above. The researchers will ask assistance from the University statistician to gain a sample size.Preliminary preparation The researchers will first send a formal letter to the Dean of Cebu Doctors’ University – College of Nursing for the approval to conduct the research study. The study questionnaires will be approved for validity by the research group’s mentor. the researchers will send transmittal letters to the barangay captains. The respective heads of the area will be informed in full disclosure as to the nature of the study. The researchers will then make and modify the tools and will be pilot tested to ensure validity. for the approval to conduct the study. After which. research coordinator and the school’s psychometrician. Actual data gathering Statistical Treatment of Data Formula: . for approval of the research study.

In this sentence. In this sentence the term 1 is used to mean that health-seeking behavior is a particular manner of an individual in finding for ways and means to be able to achieve a stable state of health. Health care facilities.is defined as something that can be used. Cebu City. In this sentence the term 2 is used to mean that accessibility is the relationship between the location of the health care services and the client’s location. and specialized care centers. such as birthing centers and psychiatric care centers. institutions. Stable health in this context is the aim of achieving age-appropriate illness prevention measures. our research title which is "Health-Seeking Behavior and Access to Health Care Facilities Among Rural Residents in Busay.Definition of Terms For the purpose of allowing the readers to understand more of our research topic. Accessibility. It describes the level of ease in affording to access the health care facility available in the area of Busay. Health-Seeking Behavior. clinics. They include hospitals.are places that provide health care. Cebu City" is broken down one by one and context by context to further explain each word independently and as related to each other. structures which are established for the main reason of delivering the health care services that they offer to . entered or reached. the term 3 is used to mean that health care facilities are places particularly buildings. outpatient care centers. approached.is a state in which a person in stable health is actively seeking ways to alter his or her personal habits or environment in order to move toward a higher level of health.

Cebu City. the term 5 is used to mean that residents are people who are currently living in the chosen area for the research study which is Busay. City of Cebu. Residents. and not very many people.is an open swath of land that has few homes or other buildings. Rural area. They are specifically the rural residents of Busay. term 4 is used to mean that rural areas are areas far from the city/ major town which has a low population density. In this sentence.the rural residents of Busay. In this sentence. .are people who reside in a particular place permanently or for an extended period of time. Cebu City who will be seeking for their services and accessing their health facilities.