Health Seeking behavior; perspective of the Marginalized Somali Community in Garissa County, a Semi-Arid Region of North Eastern Kenya

Abstract

Appropriate medical care seeking could prevent a significant number of deaths and complications due to ill health. Unfortunately, healthcare seeking behaviors (HSB) differs according to place, the affected, disease types, beliefs and the opportunities to seek care. These decisions are not isolated to individuals but are embedded in a broader household and social organizational decision process and the capacity to allow seeking of care. This descriptive cross-sectional community-based study used a multistage cluster sampling method to enrol consenting adults from different households located in the seven (7) sub-counties in Garissa County. The data were collected by interviewing 405 adult population and the answers reported in pretested structured questionnaires. Among the surveyed respondents, the mean age (±SD) was 35.17 (12.9) years, 68.1% had no formal education, 72.8% were female and 81.2% were married. Health care seeking during the latest illness was reported by three quarters of the respondents (n=293, 72.3%). The treatment or advice during the latest illness was sought by the majority in the Government / public hospitals (n=226, 55.5%), followed by in the private hospitals (n= 37, 9.1%) and among Traditional or homeopathic or spiritual healers (n = 28, 6.9%). In multivariate analysis, household headship, possession of health insurance, reasons for choosing preferred healthcare facility, durations prior to seeking treatment and the perceived three common illnesses in the community were associated with seeking treatment during the latest illness both in any of the healthcare facility and in the government/public hospitals. Gender, occupation and reasons for choosing preferred healthcare facility independently influenced seeking treatment during the latest illness both in any of the health facility and in private hospitals.  Durations prior to seeking treatment was the only independent factor associated with seeking treatment both in any of the healthcare facility and among Traditional or homeopathic or spiritual healers. During the latest illnesses among this marginalized population, appropriate health seeking behavior was significantly high with the majority preferring the government/public facilities. Gender, occupation, household headship, possession of health insurance, reasons for choosing preferred hospital, availability and the preference of current health facility, duration with illness and perceived illnesses in the community are the predictors of HSB. Improvement in education, health facilities and medical services in the community, introduction of community based integrated management of common community illness are imperative to improve HSB among the Somali community in this Semi-arid region of Kenya.

Keywords: Health seeking, Latest illnesses, Somali community, Semi-arid County of Kenya