Primary health care seeking behaviour of people with physical disabilities in Bangladesh: a cross-sectional study
Bibliographic record
Abstract
Background People with disabilities constitute about 10% of the total population of Bangladesh. They are more likely to experience poor health than those without disabilities. However, there is a lack of evidence on their primary health care (PHC) seeking behaviour for their general illness. The aim of this study was to understand the PHC seeking behaviour of people with physical disabilities (PWPDs), and to investigate the determinants of such behaviours. Methods We surveyed 282 PWPDs, aged ≥18 years, using a structured questionnaire. Participants were recruited from the out-patient department of a rehabilitation centre in Dhaka between November and December 2014. We explored PHC seeking behaviour using frequency distribution. We performed logistic regression to investigate the factors that determined their PHC seeking behaviours for general illness. In our logistic regression model, the outcome variable was whether PWPDs received treatment from a formal health care provider. The predictors were socio-demographic characteristics and clinical characteristics such as type of impairment and type of illness experienced. Results Among 282 participants, 85% suffered from general illness in the past 6 months. The participants in the higher age group, for example, age group 31–45 years (OR = 3.9, [95% CI 1.2 to 13.4]), 46–59 years (OR = 13.6, [95% CI 2.9 to 63.7) and 60+ years (OR = 12.5, [95% CI 1.7 to 93.0]) were more likely to seek treatment from formal health care providers than the age group 18–30 years. The educational attainment of the primary income earning family member (OR = 3.2, [CI 1.1 to 9.6]), religion (OR = 0.3, [95% CI 0.1 to 0.98]) and mobility aid used (OR = 4.0, [95% CI 1.2 to 13]) were determinants for seeking health care from a formal health care provider. Moreover, the type of illness suffered by participant was a strong predictor of their decision to seek treatment from a formal health care provider. The participants who suffered from urinary tract infections (OR = 10.3, [95% CI 2.3 to 46.6]), ulcers (OR = 13.1, [95% CI 2.11 to 79.3]) and pain (OR = 3.6, [95% CI 1.4 to 9.4]) were more likely to seek treatment from formal health care provider than who suffered from fever. Conclusions Age, religion, earning member's education, type of mobility aids used and type of illness suffered were explicative determinants of PHC seeking behaviour of PWPDs. The results suggest that these factors should be considered when devising interventions for this population. Moreover, accessibility, quality of care and expertise of the providers in treating disabled people were among the other factors reported by PWPDs which influence their decision to seek health care. In order to provide inclusive health services, primary health centres need to consider these determinants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".