Ecology of healthcare: Symptom prevalence and health care seeking behaviour in Gampaha District, Sri Lanka

Abstract

INTRODUCTION & OBJECTIVES: In 20 J 5, the Ministry of Health reported that 55 million outpatient visits were made to government OPDs and estimates 100 million visits by 2027. We studied the community symptom prevalence, associated factors and the trends in healthcare seeking behaviour in the Gampaha district. METHODS: A community-based prospective study, using a participant held symptom diary and interviews was conducted from May to June 20 J 8 in three Public Health Midwife areas each from Raga ma (urban) and Mirigama (rural) MOH areas. RESULTS: We invited 2330 individuals from 557 households and 2046 participated. Majority were: females. (n=l 127, 55.1%). Highest recruitment was from Mirigama area (n=1207, 59%). Of the study population 1919 (93.8%) reported at least one symptom. Phlegm (n=4871, 7.2%) had the highest frequency, musculoskeletal symptoms were the highest (26.8%) as a group. Females had a higher symptom prevalence (p = 0.001). Employment, income, having a chronic disease and distance to healthcare institution were significantly (p < 0.05) associated with both symptom prevalence and healthcare seeking behaviour. How the symptoms were managed: Ignored symptoms (n=l53, 8%), Self-care (n=560, 29.2%) and Seeking healthcare (n=924, 48.1%). Majority (n=763,82.6%) sought allopathic treatment, of whom 515 (55.7%) chose private sector ambulatory care. Of the 43 (2.2%) hospital admissions, 28 (65%) were to government hospitals. CONCLUSION: People in Gampaha District have a high symptom prevalence (93.8%) and healthcare seeking behaviour (48.1%) compared to USA which was (80%) and (32.7%) respectively. Gender did not influence the healthcare seeking behaviour. Majority (55%) preferred private allopathic ambulatory care.