Health-seeking behavior of residents of Azamgarh District, Uttar Pradesh
Rajaram Yadav, Prem ShankarAbstract
Background:
Health-seeking behavior (HSB) in low-resource settings is influenced by socioeconomic, cultural, and systemic factors. Despite India’s efforts to strengthen public health care, underutilization persists due to perceived quality gaps, accessibility issues, and institutional barriers. This study examines HSB and public healthcare utilization in Azamgarh, a socioeconomically disadvantaged district in Uttar Pradesh.
Material and Methods:
The cross-sectional community-based survey was conducted (January–May 2025) with 403 participants selected via multistage stratified random sampling. Data on sociodemographics, morbidity, and healthcare preferences were collected through structured interviews. Descriptive statistics, Chi-square tests, and logistic regression were used for analysis.
Results:
Only 16.7% of people used public healthcare facilities, with 31% citing low service quality, 14.2% citing lack of services, and 31% citing preference for reliable private providers. There were significant caste differences, with Other Backward Class and upper-caste people having 66% and 87% lower odds ratios, respectively, of using public health care than Scheduled Caste/Scheduled Tribe (SC/ST) people. Compared to communicable diseases, the likelihood of using public facilities was doubled by noncommunicable diseases (NCDs). Utilization of informal health care was found to be significantly higher among the age group 15–19 years, as compared to other age groups; also, it was higher among the people having diseases with shorter duration. Rural, lower-income, and SC/ST populations were more likely to rely on informal health care.
Conclusion:
Public healthcare underutilization in Azamgarh reflects systemic inadequacies and deep-rooted inequities. Policy interventions must address quality, trust deficits, and caste-based disparities while expanding infrastructure and financial protection schemes like the Ayushman Bharat Scheme (Pradhan Mantri Jan Arogya Yojna).