title: Rural Indian women's care-seeking behavior and choice of provider for gynecological symptoms.
abstract: This study uses data from the India National Family and Health Survey-2 conducted in 1998-99 to investigate the level and correlates of care-seeking and choice of provider for gynecological symptoms among currently married women in rural India. Of the symptomatic women surveyed, 31 percent sought care, overwhelmingly from private providers (70 percent). Only 8 percent of women consulted frontline paramedical health workers. Care-seeking behavior and type of providers consulted varied significantly across different Indian states. Significant differentials in care-seeking by age, caste, religion, education, household wealth, and women's autonomy suggest the existence of multiple cultural, economic, and demand-side barriers to care-seeking. Although socially disadvantaged women were less likely than better-off women to consult private providers, the majority of even the poorest, uneducated, and lower-caste women consulted private providers. Geographical access to public health facilities had no significant association with choice of provider, whereas access to private providers had only a moderately significant association with that choice. The predominance of use of private services for self-perceived gynecological morbidity warrants the inclusion of private providers in the national reproductive health strategy to enhance its effectiveness.
authors.affiliation: Social Welfare Department, Indian Administrative Services, Government of Rajasthan, India. manju_rani@hotmail.com
authors.forename: Manju
authors.initials: M
authors.lastname: Rani
authors.forename: Sekhar
authors.initials: S
authors.lastname: Bonu
mesh_terms: D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D005260:Female; D005831:Genital Diseases, Female / Q000208:ethnology* / Q000628:therapy; D006176:Gynecology / Q000145:classification / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D007194:India; D008393:Marriage; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011331:Private Practice / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000145:classification / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014932:Women's Health Services / Q000145:classification / Q000706:statistics & numerical data*