Healthcare seeking behavior for pain in back and extremities in rural population: a community-based estimation of treatment seeking, types and choice of care giver during a period of twelve months in rural Gadchiroli, India

Abstract

Background Population based studies to understand the current healthcare seeking behavior of the population for pain in back and extremities are lacking from rural India. We studied: (i) healthcare seeking behavior for pain in back and extremities, (ii) types of care providers sought by the community, and the (iii) factors associated with treatment seeking. Methods Two villages were randomly selected from a cluster of 39 villages in the Gadchiroli district of India. Using predetermined criteria, all resident adults ≥ 20 years, were surveyed in January 2010 by the trained community health workers (CHW) by making household visits. Using a structured, pretested questionnaire, they inquired and recorded the history of pain in back and extremities and health care seeking for the same during the previous 12 months. Results Out of 2535 eligible adults in two villages, 2259 (89%) were interviewed. A significant proportion of the participants with back pain and pain in the extremities sought treatment (86.99%). The maximum number of individuals sought care from private providers (64.64%) followed by home remedies (61.64%), government facilities (17.03%), community health workers (CHW) of Society for Education, Action and Research in Community Health (SEARCH) (12.87%), Bengali doctors (5.7%) and traditional healers (6.56%). Almost equal number of participants with any back pain (88.88%) and any extremity pain (88.95%) sought treatment. The care seeking was significantly more for female participants (odds ratio, OR=1.83, 95% confidence interval, CI=1.32–2.5), in case of severe pain (OR=2.0, 95% CI=1.29–3.12) and in the age group 51 to 60 years (OR=2.04, 95% CI=1.14–3.67). Conclusions A significant number of the individuals with back pain and pain in the extremities in rural Gadchiroli seek care, mainly from private practitioners and resort to application of home remedies whereas the care seeking from the public health facilities is considerably less. Hence there is need to provide care for pain in back and extremities in the public healthcare system.