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Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings

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  • Alayne M Adams
  • Rubana Islam
  • Sifat Shahana Yusuf
  • Anthony Panasci
  • Nancy Crowell
Abstract
Introduction: Accompanying rapid urbanization in Bangladesh are inequities in health and healthcare which are most visibly manifested in slums or low-income settlements. This study examines socioeconomic, demographic and geographic patterns of self-reported chronic illness and healthcare seeking among adult slum dwellers in Bangladesh. Understanding these patterns is critical in designing more equitable urban health systems and in enabling the country’s goal of Universal Health Coverage by 2030. Methods: This descriptive cross-sectional study compares survey data from slum settlements located in two urban sites in Bangladesh, Tongi and Sylhet. Reported chronic illness symptoms and associated healthcare-seeking strategies are compared, and the catastrophic impact of household healthcare expenditures are assessed. Results: Significant differences in healthcare-seeking for chronic illness were apparent both within and between slum settlements related to sex, wealth score (PPI), and location. Women were more likely to use private clinics than men. Compared to poorer residents, those from wealthier households sought care to a greater extent in private clinics, while poorer households relied more on drug shops and public hospitals. Chronic symptoms also differed. A greater prevalence of musculoskeletal, respiratory, digestive and neurological symptoms was reported among those with lower PPIs. In both slum sites, reliance on the private healthcare market was widespread, but greater in industrialized Tongi. Tongi also experienced a higher probability of catastrophic expenditure than Sylhet. Conclusions: Study results point to the value of understanding context-specific health-seeking patterns for chronic illness when designing delivery strategies to address the growing burden of NCDs in slum environments. Slums are complex social and geographic entities and cannot be generalized. Priority attention should be focused on developing chronic care services that meet the needs of the working poor in terms of proximity, opening hours, quality, and cost.

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  • Alayne M Adams & Rubana Islam & Sifat Shahana Yusuf & Anthony Panasci & Nancy Crowell, 2020. "Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-18, June.
    • Handle: RePEc:plo:pone00:0233635
    DOI: 10.1371/journal.pone.0233635
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    References listed on IDEAS

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    1. Palacios, Alfredo & Gabosi, Julia & Williams, Caitlin R. & Rojas-Roque, Carlos, 2022. "Social vulnerability, exposure to environmental risk factors, and accessibility of healthcare services: Evidence from 2,000+ informal settlements in Argentina," Social Science & Medicine, Elsevier, vol. 309(C).
    2. Kamrun Nahar Koly & Md. Saiful Islam & Daniel D Reidpath & Jobaida Saba & Sohana Shafique & Md. Razib Chowdhury & Farzana Begum, 2021. "Health-Related Quality of Life among Rural-Urban Migrants Living in Dhaka Slums: A Cross-Sectional Survey in Bangladesh," IJERPH, MDPI, vol. 18(19), pages 1-13, October.
    3. Olufunke Fayehun & Motunrayo Ajisola & Olalekan Uthman & Oyinlola Oyebode & Abiola Oladejo & Eme Owoaje & Olalekan Taiwo & Oladoyin Odubanjo & Bronwyn Harris & Richard Lilford & Akinyinka Omigbodun & , 2022. "A contextual exploration of healthcare service use in urban slums in Nigeria," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-14, February.

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