Differences in health care seeking behaviour between rural and urban communities in South Africa

Int J Equity Health. 2012 Jun 12;11:31. doi: 10.1186/1475-9276-11-31.


Objective: The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population.

Design: A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected.

Results: The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988).

Conclusion: Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Attitude to Health
  • Cross-Sectional Studies
  • Delivery of Health Care / statistics & numerical data
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Health Status
  • Health Status Disparities
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Rural Population / statistics & numerical data*
  • Socioeconomic Factors
  • South Africa / epidemiology
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data*