Health Care Behavior Study: Results and interpretations on findings

The interview and the data generated:

Lot of information is revealed in this research study about the prevailing socio-economic and demographic contexts of the rural population under Rajshahi Division from the in-depth interviews of the sample respondents. These are the factors influencing individuals mind for the health care behavior and existing in the rural community under Rajshahi Division and possibly in other rural areas of Bangladesh with little variation as similar socioeconomic features are present there (the reasons mentioned in the methodology section). The main thrust of the research study was to investigate and document the knowledge, attitude and practices those result from the health care behavior of the individual and their relation with the existing social factors in the community. In this study, huge amount of information were generated by skillful utilization of the data collection instrument prepared by the researcher with decade long experiences in health research and programs. These can be preserved for future use as secondary data by similar research. Only some of the information generated in the study having deep relations with the objectives of the study is presented for discussion. Some of them are related to the social factors influencing individual for his health care behavior describing the number, gender, age, education, income earning, and religion etc. It can be noted that these information came from a sample population and for that only capable of representing only the “in general” features of the vast total population inhabiting Rajshahi Division. Although very few in number like other parts of Bangladesh, there are rich people in Rajshahi Division in comparison to the general and according to the common knowledge, northern, i.e. Rajshahi Division is the poorest among the total six administrative Divisions in Bangladesh.

In the discussion, attempts will be made to clarify the results given in the previous chapter in tabular forms for as a result of the thorough investigation of the health care behavior of the rural people under Rajshahi Division and to relate them with the social factors which influenced their development.

Environment of the interview:

For the planned in-depth interview of the respondents i.e. the rural population for qualitative data, data collection instrument had been designed carefully as a qualitative questionnaire having mostly unstructured questions with general outlines of the topics. Unprompted clarifications were obtained by skillful follow-up questions. From the very beginning, the respondents were kept carefully unprovoked and no leading questions were put. Biasness was carefully avoided. They were totally free to discuss their topics in their own style. Interviewers just tried them to keep the respondents in the topic tracts and not to deviate much except when necessary.

In most cases, the respondents showed considerable interest to discuss the issues, which they thought and perceived as their own stories and matters of their everyday life. It was a success for the researcher that the discussions could be placed in the huts, courtyards or under the trees of the rural villages in the Rajshahi Division where all the elements regarding the myths with their associations with livelihoods of the populations were seemed to prevail. Abundance of trees makes the rural Bangladeshi villages as intense dark shadowed places which become darker with the dusk and become darkest at the nights. In Bangladeshi rural areas as it is in the Rajshahi Division, the natural bushes and the shadows, constituted by bunch of bamboo and varieties of trees, create and maintains a mysterious environment as mentioned earlier in general capable of exerting influences on the human lives, their culture, their traditional beliefs and on their practices in different issues over the centuries. The morale of the research was depended on the mentioned range of social factors usually influence their mind through contexts of their traditional beliefs, culture and their practices with a behavioral study like health care behavior. So, while conducting the in-depth interviews, people were free to express feelings, their imaginations, and perceptions, sometimes those were beyond reality, occasionally seemed as mythical! In their expressed traditional beliefs, there were delusions, super values, creativities etc. Underlying psychology of their health care behavior was reflected through their responses, which had been originated and modified by the social factors forming the basis of the mentioned psychology or behavior. They were not disturbed for the interviews in their busy times for livelihood; rather the interview times were taken from them with their own choice. More over, when the female head of the household (what was our priorities for different reasons) were not allowed to talk with the interviewers, we talked with the male head as per their choices. The researcher took proper care while asking “sensitive questions” in the sexual or other “forbidden” contexts.

Psychosocial Factors related to the Health Care Behavior of the Rural People under Rajshahi Division

Objectives	Tasks to achieve the objectives/indicators
1. To determine and explore the psychosocial and cultural norms, values, practices and beliefs prevailing in the rural population under Rajshahi Division that influences health care behavior of the rural contributing in their psychological getups/preparedness/ perception of disease.	-Traditional and religious beliefs, norms, cultures, general practices and values related to health care behavior of the sampled rural population under Rajshahi Division are unveiled by the study. -Their influences and impacts on health care behavior is explored.
2. To explore the disease trends with the diseases of psychological importance, home management and home caretakers of the disease, extents of faith on home management, source of information in the contexts, traditional remedies etc. among the rural population under Rajshahi Division	-Common disease trends in the sampled population of rural Rajshahi Division are observed. -Diseases of psychological importance are followed. -Extent of home management, associated confidence and skills, caretakers of the patients, source of the information/skills and traditional remedies are investigated and documented.
3. To determine whether the prevailing economic conditions, education, religion, profession, health status, distances from hospitals, gender, associated stigma and other factors of the different population groups in rural population under Rajshahi Division play facilitator’s role for exposing the rural population groups to the health care services whatever available there.	-Influences and impact of economic condition, education, religion, profession, health status, gender, distance from hospital or doctor’s chamber, associated social stigma and other factors on health care behavior of the rural people under Rajshahi division are explored. - Extents of the influence of the mentioned factors on their exposure to available health care facilities are explored.
4. To assess the knowledge, attitude, practice, perception and awareness levels of rural population under Rajshahi Division towards etiology, course, and traditional management of different common and important diseases and also about their preference and satisfactions towards different health care services facilities available in the locality. To investigate the environment, quality of care and other issues including the privacy context for the patients etc. in those service delivery facilities. Also to explore the role of different types of health service providers including Government and NGO for service delivery for the rural population in Rajshahi Division.	-Knowledge Attitude, Perception (KAP) and awareness levels of the sampled population towards the causes of the diseases, courses and traditional managements of the common and important diseases are explored and investigated. -Service seekers satisfaction level in disease management by the service providers (Doctors/traditional healers etc.) and their preference of treatment outlets have been investigated. -Quality of the health care service, environment of the hospitals/treatment centers with privacy issue has been investigated. -Health care seekers’ perceptions about different types of health service providers including Government and NGO health centers have been investigated for the sampled population.
5. To investigate and unveil the social cohesiveness and emotional/psychosocial climates that now prevailing between the service providers and the recipients. .	- Behavior, attitude, sincerity and commitments of the different health service providers and their emotional/social climates with service seekers have been investigated.
6. To assess the qualitative coverage of the existing health service facilities including the NGOs present in the rural Rajshahi Division in regards to the prevailing common diseases, its impacts on the population and needs for services.	-Coverage of the existing health service facilities including those of the Government and NGO have been explored and investigated. -Influences and impacts of that coverages have been investigated for the sampled population of the rural people under Rajshahi Division.