|BRIEF RESEARCH ARTICLE
|Year : 2019 | Volume
| Issue : 2 | Page : 151-153
Why people avoid prescribed medical treatment in India?
Shivendra Sangar1, Varun Dutt2, Ramna Thakur2
1 PhD Scholar, School of Humanities and Social Sciences, Indian Institute of Technology, Mandi, Himachal Pradesh, India
2 Assistant Professor, School of Humanities and Social Sciences, Indian Institute of Technology, Mandi, Himachal Pradesh, India
|Date of Web Publication||18-Jun-2019|
A3 Building, South Campus, Indian Institute of Technology, Kamand, Mandi - 175 005, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Avoidance in seeking prescribed medical treatment can result in adverse consequences. The study was conducted to find out the reasons to avoid prescribed medical treatment and associations with various socioeconomic variables in India. Data from the National Sample Survey Organisation 71st Round on “Key Indicators of Social Consumption: Health” (January and June 2014) have been used. Variables such as place of residence, social categories, religion, and socioeconomic status have been used to study the associations with the various reasons to avoid prescribed medical treatment. Nonseriousness about the ailment was found to be the primary reason for not seeking prescribed medical treatment. Lack of availability of medical facility, long-waiting time, and financial constraints were other important reasons. Understanding the socioeconomic differentials among the reasons why people avoid prescribed medical treatment is critical in improving the effectiveness of health-care facilities in India.
Keywords: Avoid, medical treatment, prescribed, socioeconomic
|How to cite this article:|
Sangar S, Dutt V, Thakur R. Why people avoid prescribed medical treatment in India?. Indian J Public Health 2019;63:151-3
|How to cite this URL:|
Sangar S, Dutt V, Thakur R. Why people avoid prescribed medical treatment in India?. Indian J Public Health [serial online] 2019 [cited 2020 Apr 5];63:151-3. Available from: http://www.ijph.in/text.asp?2019/63/2/151/260598
In low- and middle-income countries like India, people often avoid prescribed medical treatment even when they suffer from the ailment a most. Avoidance in seeking prescribed medical treatment can result in the detection of ailment at the later stage and reduce the chances of survival., Studies have shown that in India, around 50% of the patients suffering from noncommunicable diseases (NCDs) like cancer report to the hospital in the later stage when the disease becomes incurable.
There are many factors such as nonavailability of health-care facility, financial constraints, and overcrowdedness of the hospitals which play a significant role in the delay in seeking prescribed medical treatment. In addition, socioeconomic variables such as place of residence, social setup, and religion also have an important bearing on the avoidance of prescribed medical treatment in India. Although this is a common practice and has serious consequences, in India, the literature on the same is very limited. To encourage people to get medical treatment well in time, it is essential to deliberate the reasons for avoiding the same. In this direction, this study aims at analyzing the underneath reasons of avoiding prescribed medical treatment among different socioeconomic, rural–urban, and religious groups in India.
This study used the cross-sectional data from the National Sample Survey Organisation (NSSO) 71st Round on “Key Indicators of Social Consumption: Health” conducted between January and June 2014. A total of 65,932 households consisting of 333,105 individuals were surveyed in this round. Of which, 36,200 individuals reported ailment, and among them, 3431 did not seek medical treatment and gave different reasons for not seeking prescribed medical treatment. We have used the variables such as place of residence (rural and urban), social categories (scheduled tribes [STs], Scheduled Castes (SCs), other backward classes [OBCs], and general), religion (Hinduism, Islam, and others), and socioeconomic status (the poorest, poor, middle, rich, and richest) of the study group to underpin the associations, if any, between these variables and the various reasons to avoid prescribed medical treatment in India.
Ethical approval – This paper is based on anonymized survey data collected by the NSSO, a Department of the Ministry of Statistics and Programme Implementation, Government of India. Therefore, this analysis does not need any ethical approval from the authors' side.
In this study, we found that in India, nonseriousness about the ailment is the primary reason (61.3%) for not seeking prescribed medical treatment. It is higher in urban areas (69.1%) as compared to rural areas (58.2%). Among different social categories, OBCs are at the top in not taking ailment seriously (66.1%) followed by general (59.3%), scheduled castes (54.7%), and STs (51.9%). Similarly, variations also exist among different religious groups in not considering ailment serious as a reason not to take prescribed medical treatment. Among different socioeconomic status, the poor (65.8%) are the ones who avoid medical treatment because of the same reason [Table 1].
|Table 1: Reasons for not seeking medical treatment among different socioeconomic covariates in India|
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Lack of availability of medical facility in the neighborhood is the second most important reason. Around 15.4% in rural areas as compared to only 1.3% in urban areas reported the lack of medical facility in their vicinity as the reason. Similarly, among social categories, a higher proportion of STs (19%) than other categories reported the same reason. Among different religions, Muslims (22.4%) in much higher proportion than other religious groups also reported the lack of medical facility as the reason. Further, among socioeconomic groups, the poorest (19.1%) as compared to other groups avoid seeking prescribed medical treatment due to the same reason in the country.
In addition, to have a medical facility in the neighborhood, it is also imperative that it should satisfy people's aspirations in the treatment. In India, 3.3% of the population avoiding medical treatment report the lack of satisfactory quality of health-care facility as the main reason. Rural–urban differentials also exist as 3.8% in rural, and 2% in urban areas regard the unsatisfactory quality of health-care facility as the reason for not seeking prescribed treatment. Among social categories, STs (7.5%) in higher proportion followed by others also report the same reason for not getting prescribed treatment.
Among total population who do not seek prescribed medical treatment in spite of having an ailment, 6% (slightly higher figures in rural India) reported expensive health-care treatment as a cause for not seeking prescribed medical treatment. Among different social categories, a substantial percentage of population among STs (13.1%) followed by SCs (9%), OBCs, and general (4.4%) also reported financial constraints as a reason. Among different religions, a reasonable percentage of other religions also reported the same reason. Based on socioeconomic status, the poorest (10%) also reported the same for avoiding the prescribed treatment.
Another important reason reported to avoid prescribed medical treatment is the long-waiting time taken in the health-care facility. In India, of total prescribed treatment avoiding population, 3.2% reported long waiting time (with a little higher in rural areas) in the health-care facility as the main reason for the avoidance of the same. Similarly, variations also exist among different social and economic groups in the avoidance of prescribed medical treatment due to long waiting.
Findings of the study revealed that about 60% of the population avoiding prescribed medical treatment do not consider their ailment serious enough to seek medical treatment. More often people do not take the symptoms seriously and avoid seeking medical treatment. Due to lack of medical awareness, people are ignorant about their health-care needs which lead them to avoid seeking prescribed medical treatment. Later on, it could become life-threatening as it happens in some NCDs, like cancer.
Results also show that a significant proportion of the population reported the nonavailability of health-care facility in their neighborhood as the major cause of not getting medical treatment in spite of having an ailment. Unsatisfactory medical facility available in the vicinity and long waiting time to get treatment are also some of the reasons which play an important role in deciding whether to have a medical treatment or not.
Often rural areas suffer from the lack of trained medical personnel who compel people to seek prescribed medical treatment in urban areas. It results in the overcrowding at the health-care facilities in the urban areas which becomes one of the reasons of avoiding prescribed medical treatment for others. According to the Rural Health Survey 2017, India lacks the required number of community health centers, primary health centers, and subcenters (SCs) as per the set requirements and resulted in more pressure on the existing facility and long waiting time. Inadequate access to quality health-care facilities also deters people to seek prescribed medical treatment.
Due to the lack of universal health coverage system in India, financial constraints also dissuade people from seeking prescribed medical treatment. In India, people have to bear the expenditure of medical treatment which sometimes is out of their ability to pay. This situation leaves two options in front of poor and vulnerable sections of the population either to get treatment at the cost of minimum food requirements of the family and drag them into deep poverty or to go without treatment, and they mostly prefer the second option. It leads to an increased probability of morbidity among the economically weaker sections. Governments both at the center and state level introduced many publicly financed health insurance schemes for these sections of the society but are not successful in showing the substantial impact on the reduction of the cost of illness. We conclude that understanding the socioeconomic differentials among the reasons why people avoid prescribed medical treatment is critical to improving the effectiveness of health-care facilities in India.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Taber JM, Leyva B, Persoskie A. Why do people avoid medical care? A qualitative study using national data. J Gen Intern Med 2015;30:290-7.
Byrne SK. Healthcare avoidance: A critical review. Holist Nurs Pract 2008;22:280-92.
Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg 2007;31:1031-40.
National Sample Survey Organization. Key indicators of Social Consumption in India: Health, 71st
Round (January-June 2014). New Delhi: Ministry of Statistics and Programme Implementation, Government of India; 2014.
Pakseresht S, Ingle GK, Garg S, Sarafraz N. Stage at diagnosis and delay in seeking medical care among women with breast cancer, Delhi, India. Iran Red Crescent Med J 2014;16:e14490.
Singh S, Badaya S. Health care in rural India: A lack between need and feed. South Asian J Cancer 2014;3:143-4.
] [Full text]
Ministry of Health and Family Welfare, Government of India. Rural Health Statistics2014-15. New Delhi, India: Ministry of Health and Family Welfare, Government of India; 2017.
Van Minh H, Kim Phuong NT, Saksena P, James CD, Xu K. Financial burden of household out-of pocket health expenditure in Viet Nam: Findings from the national living standard survey 2002-2010. Soc Sci Med 2013;96:258-63.
Bourne PA. Impact of poverty, not seeking medical care, unemployment, inflation, self-reported illness, and health insurance on mortality in Jamaica. N Am J Med Sci 2009;1:99-109.
Prinja S, Chauhan AS, Karan A, Kaur G, Kumar R. Impact of publicly financed health insurance schemes on healthcare utilization and financial risk protection in india: A systematic review. PLoS One 2017;12:e0170996.