SOCIAL CULTURE, HEALTH SEEKING

BEHAVIOR AND MEDICAL PLURALISM

Objectives
 Recognize health seeking behavior
 Identify approaches of health seeking behavior
 Compare case on health seeking behavior in TB,
maternal and child health, HIV and Diabetes
 Compose health-seeking behavior model from
medical psychology, social psychology & medical
anthropology
 Health Seeking Behavior

“study on what facilitate the use of health services and what

influences people to behave differently in relation to their
health”
--MacKian, 2003

Divided into 2 approaches:

1. Health-care Seeking Behavior: utilization of the system
2. Health Seeking Behavior: illness response
 Health Seeking Behaviors vs.
Health Care Seeking Behaviors
Health-care seeking behavior Health seeking behavior
(utilization of the system) (illness response)
Focus End Point (utilization of formal system) Process (factors which enable or
prevent people from making
‘healthy choices’)
Variables to • Demographic factor • Demographic factor
predict behavior • Social status • Social factor
patterns • Socio-economic factor • Emotional factor
• Type of illness • Cognitive factor
• Access to services • Personality
• Perceived quality of services • Perceived symptoms
• Access to care
Limitation The desired outcome (seeking help in Focus on the individual and the
formally recognize health setting) is centrality of cognitive process,
barely applicable, because some people therefore loose the senses that
will first chose traditional healers, village social context affected the way
homeopaths or untrained allopathic people process and act on
doctor information
Approaches
 Knowledge-Attitude-Practice (KAP) Study
 Highly descriptive data, without explanation on why people do what
they do
 Limitation: neglecting motivational factors, stigma, treatment
expectations, satisfaction with health services, decision making factors
and health barriers
 Focus Ethnographic Studies (FES) and Rapid Assessment
 Aim: to identify local illness concepts and categories
 ‘Emic’ concept: ‘the native view’ of illness as oppossed to the ‘health
professionals’ view’
 Use variety of techniques, with a particular emphasis on qualitative
methods
Cases of Health Seeking Behavior
 Health seeking behavior varies for the same individuals or
communities when faced with different illness, for examples:
 Tuberculosis
 Tend to do multiple health seeking behavior that influenced by health
system, community, family and other personal issues
 Patient prefer private service for more polite, more effective, more
sympathetic & respectful of privacy services
 Because of its lengthy treatment period, patient-doctor relationship is
crucial
 Diabetes
 The behavior change depends on person’s self efficacy and
outcome expectation
 Tend to have weaker beliefs in health care professional, therefore
patient-doctor relationship is important
Cases of Health Seeking Behavior
(cont’d)
 Maternal and Child Health
 Women rely on the male head of household to secure access to
medical treatment, financially and practically
 ‘Elements of livelihood’ that affect women capacity to obtain
treatment: income, social status, social life, networks, autonomy and
liability
 HIV/STIs
 Pathway model to HIV infection consist of: social factors, psychosocial
mediators, behavioral pathways and/or physical pathways
 The approach for sexual behavior change is more complex than
traditional health promotion approaches (KAP)
 Collective approach might help patient change the behavior actively
rather than individualised passive approach
Health Seeking Behavior Model
 Health seeking behavior models in public health serve as
catalogues of relevant variables rather than as behavioral
models themselves
 Aim: to identify problematic areas in order to intervene with
specific health system strategies
 Models derived from Social Psychology:
 Health Belief Models
 Theory of Reasoned Action-Theory of Planned Behavior
 Models derived from Medical Sociology
 Health Care Utilization/Social-Behavioral Model
 Models derived from Medical Anthropology
 Decision Making Model
TERIMA KASIH
References
 Hausmann-Muela, S., Ribera, J.M. & Nyamongo, I., 2003.
Health-seeking Behavior and The Health System Response
 MacKian, S., 2003. A Review of Health Seeking Behavior:
Problem and Prospects