Document Type : Original Article


1 Research Center for Traditional Medicine and History of Medicine

2 Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran


INTRODUCTION: Health systems aimed to increase health utilization. Habits and behavior about
using health facilities, which is called health-seeking behavior, are different among different cultures
and influenced by different factors. The present study is aimed at investigating Iranian Southern
population health‑seeking behavior and its influencing factors.
MATERIALS AND METHODS: Asample of 397 people was selected using proportional stratified random
sampling for this cross‑sectional study. They were asked to fill a questionnaire about their health‑seeking
behaviors (seeking treatment, inattention to treatment, and self-medication) and socioeconomic factors.
Data were analyzed using regression models including linear, ordinal, and logistic regressions.
RESULTS: Near 80% of participants reported self‑medication and most of them prefer public hospitals
as their first point of contact with health system compared to others such as family physician. Using
linear regression revealed seeking treatment has significant relationship with age (P = 0.037), living
place (P = 0.018), and having complementary insurance (P = 0.013). Self‑medication behavior has
relation with age (P = 0.015), gender (P = 0.039), education years (P = 0.031), living place (P = 0.005),
having complementary insurance (P = 0.001), and satisfaction with health‑care providers (P = 0.003)
in logistic regression. Using ordinal regression, it was found that inattention to treatment has
a relation with education years (P = 0.044), living place (P = 0.042), having complementary
insurance (P = 0.049), and severity of illness (P = 0.031).
CONCLUSION: Southern population does not accept family physician as the first point of interaction
with the health system, and they prefer to go to public hospitals directly. Moreover, self-medication
is a prevalent behavior among the population and thus their acceptance of health care is low. Based
on the findings, it can be suggested providing more satisfying health care, increasing insurance
coverage, and informing population could lead to better utilization of health‑care services.


  1. World Health Organization. The World Health Report 2000:
    Health Systems: Improving Performance. World Health
    Organization; 2000.
    2. Slobbe LC, Wong A, Verheij RA, van Oers HA, Polder JJ.
    Determinants of first‑time utilization of long‑term care services
    in the Netherlands: An observational record linkage study. BMC
    Health Serv Res 2017;17:626.
    3. Musoke D, Boynton P, Butler C, Musoke MB. Health seeking
    behaviour and challenges in utilising health facilities in Wakiso
    district, Uganda. Afr Health Sci 2014;14:1046‑55.
  2. 4. Chan CQ, Lee KH, Low LL. A systematic review of health
    status, health seeking behaviour and healthcare utilisation of
    low socioeconomic status populations in urban Singapore. Int J
    Equity Health 2018;17:39.
    5. Samal J. Health seeking behaviour among tuberculosis patients
    in India: A systematic review. J Clin Diagn Res 2016;10:LE01‑6.
    6. Thompson AE, Anisimowicz Y, Miedema B, Hogg W,
    Wodchis WP, Aubrey‑Bassler K, et al. The influence of gender
    and other patient characteristics on health care‑seeking behaviour:
    A QUALICOPC study. BMC Fam Pract 2016;17:38.
    7. Dhawan A, Chopra A, Ambekar A, Ray R. Treatment
    seeking behavior of inhalant using street children: Are we
    prepared to meet their treatment needs. Indian J Psychol Med
    8. Boerema AM, Kleiboer A, Beekman AT, van Zoonen K,
    Dijkshoorn H, Cuijpers P, et al. Determinants of help‑seeking
    behavior in depression: A cross‑sectional study. BMC Psychiatry
    9. Waetjen LE, Xing G, Johnson WO, Melnikow J, Gold EB; Study of
    Women's Health Across the Nation (SWAN). Factors associated
    with seeking treatment for urinary incontinence during the
    menopausal transition. Obstet Gynecol 2015;125:1071‑9.
    10. Pourreza A, Kabiri R, Arab M, Akbari Sari A, Rahimi A, Toll A.
    Healthcare-seeking behavior in Tehran, Iran and factors affecting
    it. Journal of School of Public Health and Institute of Public Health
    Research 2009;7:1-13.
    11. Rashidi S, Yazdanpanah A, Aghayiibarzabad P. Evaluating
    treatment-seeking behavior and the related factors among the
    dwellers of Safashahr city. Asian J Pharm Clin Res 2017;10:144-9.
    12. Starfield B. Book Review: Primary care: Balancing health needs,
    services, and technology. Int J Integr Care 2001;1:1‑2.
    13. Nasirian M, Karamouzian M, Kamali K, Nabipour AR,
    Maghsoodi A, Nikaeen R, et al. Care seeking patterns of
    STIs‑associated symptoms in Iran: Findings of a population‑based
    survey. Int J Health Policy Manag 2015;5:5‑11.
    14. O’Neill S, Gryseels C, Dierickx S, Mwesigwa J, Okebe J,
    d’Alessandro U, et al. Foul wind, spirits and witchcraft: Illness
    conceptions and health‑seeking behaviour for malaria in the
    Gambia. Malar J 2015;14:167.
    15. Borhaninejad V, NaghibizadehTahami A, Nabavi H, Rashedi V,
    Yazdi-Feyzabadi V. The utilization of health services and its
    influences among elderly people in Kerman-2014. North Khorasan
    University of Medical Sciences 2015;7:229-40.
    16. Delavari S, Arab M, Rashidian A, Nedjat S, Souteh RG.
    A qualitative inquiry into the challenges of medical education
    for retention of general practitioners in rural and underserved
    areas of Iran. J Prev Med Public Health 2016;49:386‑93.
    17. Azami‑Aghdash S, Mohseni M, Etemadi M, Royani S, Moosavi A,
    Nakhaee M, et al. Prevalence and cause of self‑medication in Iran:
    A systematic review and meta‑analysis article. Iran J Public Health
    18. Grigoryan L, Haaijer‑Ruskamp FM, Burgerhof JG, Mechtler R,
    Deschepper R, Tambic‑Andrasevic A, et al. Self‑medication with
    antimicrobial drugs in Europe. Emerg Infect Dis 2006;12:452‑9.
    19. Garofalo L, Di Giuseppe G, Angelillo IF. Self‑medication practices
    among parents in Italy. Biomed Res Int 2015;2015:580650.
    20. Lee CH, Chang FC, Hsu SD, Chi HY, Huang LJ, Yeh MK,
    et al. Inappropriate self‑medication among adolescents and its
    association with lower medication literacy and substance use.
    PLoS One 2017;12:e0189199.
    21. Shamshirian A, Ghorbanpour A, Jahanpanahi B, Mohammadyan M,
    SedaghatNezhad R, Karami M. Assessment of the knowledge and
    attitude of pharmaceutical students around self-medication,
    common medicines and DPIC. International Journal of Advanced
    Biological and Biomedical Research 2017;6:465-70.
    22. Adhikary M, Tiwari P, Singh S, Karoo C. Study of self-medication
    practices and its determinants among college students of Delhi
    University North Campus, New Delhi, India. International
    Journal of Medical Science and Public Health 2014;16:119.
    23. Kumar V, Mangal A, Yadav G, Raut D, Singh S. Prevalence and
    pattern of self-medication practices in an urban area of Delhi,
    India. Medical Journal of Dr. D.Y. Patil University 2015;8:16.
    24. Jain S, Malvi R, Purviya JK. Concept of self medication: A review.
    Int J Pharm Biol Arch 2011;2: 831-6.
    25. Hayati H, Khosravi B, Kebriaeezadeh A, Khanizade M. Study
    of self-medication status among referring patients to Kashan
    pharmacies. Journal of Pharmacoeconomics and Pharmaceutical
    Management 2015;1:45-8.
    26. Papakosta M, Zavras D, Niakas D. Investigating factors of self‑care
    orientation and self‑medication use in a Greek rural area. Rural
    Remote Health 2014;14:2349.
    27. Ahmad A, Patel I, Mohanta G, Balkrishnan R. Evaluation of self
    medication practices in rural area of town Sahaswan at Northern
    India. Ann Med Health Sci Res 2014;4:S73‑8.
    28. Galdas PM, Cheater F, Marshall P. Men and health help‑seeking
    behaviour: Literature review. J Adv Nurs 2005;49:616‑23.
    29. WeissmanMM, KlermanGL. Sex differences and the epidemiology
    of depression. Arch Gen Psychiatry 1977;34:98‑111.
    30. Macintyre S, Ford G, Hunt K. Do women ‘over‑report’ morbidity?
    Men’s and women’s responses to structured prompting on
    a standard question on long standing illness. Soc Sci Med
    31. Heydartabar R, Hatefnia E, Kazemnejad A, Ayubi E, Mansori K.
    The effects of model-based educational intervention on selfmedication behavior in mothers with children less than 2-year.
    International Journal of Pediatrics 2016;4:3229-38.
    32. Shamsi M, Tajik R, Mohammad BA. Effect of education based
    on health belief model on self-medication in mothers referring
    to health centers of Arak. Arak Medical University Journal
    33. Figueiras A, Caamaño F, Gestal‑Otero JJ. Sociodemographic
    factors related to self‑medication in Spain. Eur J Epidemiol
    34. Machado‑Alba JE, Echeverri‑Cataño LF, Londoño‑Builes MJ,
    Moreno‑Gutiérrez PA, Ochoa‑Orozco SA, Ruiz‑Villa JO,
    et al. Social, cultural and economic factors associated with
    self‑medication. Biomedica 2014;34:580‑8.
    35. Jafari F, Khatony A, Rahmani E. Prevalence of self‑medication
    among the elderly in Kermanshah‑Iran. Glob J Health Sci
    36. Abosede OA. Self‑medication: An important aspect of primary
    health care. Soc Sci Med 1984;19:699‑703.
    37. Aqeel T, Shabbir A, Basharat H, Bukhari M, Mobin S,
    Shahid H, et al. Prevalence of self-medication among urban and
    rural population of Islamabad, Pakistan. Tropical Journal of
    Pharmaceutical Research 2014;13:627-33.
    38. Lei X, Jiang H, Liu C, Ferrier A, Mugavin J. Self‑medication
    practice and associated factors among residents in Wuhan, China.
    Int J Environ Res Public Health 2018;15. pii: E68.
    39. Dineshkumar B, Raghuram TC, Radhaiah G, Krishnaswamy K.
    Profile of drug use in urban and rural India. Pharmacoeconomics
    40. Stein CM, Gora NP, Macheka BM. Self‑medication in urban
    and rural Zimbabwean communities. Br J Clin Pharmacol
    41. Pagán JA, Ross S, Yau J, Polsky D. Self‑medication and health
    insurance coverage in Mexico. Health Policy 2006;75:170‑7.
    42. Pagán JA, Puig A. Differences in access to health care services
    between insured and uninsured adults with diabetes in Mexico.
    Diabetes Care 2005;28:425‑6.