Health seeking behavior

Ova Emilia

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• Ruli mengalami nyeri perut dan
punggung hilang timbul sejak 3 bulan
terakhir. Nyeri tersebut hilang bila
minum asam mefenamat. Ibunya
menyarankan Ruli untuk urut “siapa tahu
ada organ yang tidak pas tempatnya”.
Kakaknya mendorong Ruli untuk periksa
ke puskesmas atau Rumah sakit. Ruli
tidak peduli dengan saran itu.

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 Mengapa perlu dipahami?
• Diare • Kanker

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Health Belief Model
(Rosenstock, 1974, cited in Jones, 2003)

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 Health behavior
• Preventive health behavior intended to
reduce susceptibility to disease, as well as to reduce the
effects of chronic diseases when they occur in the
individual

• Illness behavior related to the control of a

disease that an individual has or that is incipient in the
individual

• Sick role behavior. directed towards reducing

the impact and progression of symptomatic disease in the
individual.

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 Hubungan timbal balik

Consumer Provider

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 What is health seeking behavior
• The process of responding to „illness‟ or seeking
care

Dokter Rumah
Beli obat
terdekat sakit

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When a family member sick

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Access to health facility

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Cost of health care

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 What is health seeking behavior
Dipengaruhi oleh faktor

Si kon
Budaya

Sosial

Personal

Pengalaman

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 What is health seeking behavior
• Involves multiple steps (Uzma et al,
1999), and can rarely be translated
into a simple one of choice or act,
or be explained by a single model of
health seeking behaviour.

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 Penting
• Memahami bagaimana masyarakat
masuk dalam sistem pelayanan
kesehatan

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Health Good health
promotion seeking behavior

Is not sufficient Individual

Element
dynamic,
collective,
interactive

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 Dua pendekatan
health seeking behavior

1. Menekankan pada „end point‟

(utilisation of the formal system,
or health care seeking behaviour);
2. Menekankan pada„process‟ (illness
response, or health seeking
behaviour).
Tipping and Segall (1995).
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Health seeking behavior issues

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 Tuberculosis
• a classic public health issue

• effective diagnosis, treatment and

control are important for the
whole of a society.

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 Tuberculoasis
• Late presentation and delayed
diagnosis are key problems
• When occurs, reflecting both
individual and social factors, and
system failures.
• Delay can be related to social
stigma, gender, fear or „multiple
health seeking behavior‟.
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 Tuberculosis
• Understanding of health seeking
behaviour may improve treatment
compliance and shorten delay to
diagnosis.
• Health education should be promoted at
family and community level.
• „Multiple health seeking‟ with better co-
operation between public and private
providers in particular.
• The doctor-patient relationship.
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 MCH
Maternal health and health
seeking behaviour of
mothers have a huge impact
not only on the lives of
women, but also on the
lives of their children.

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 MCH
• The way in which women reach the
decisions
• Improve women‟s embededness in
health systems and social structures
that is as yet under-developed in the
literature.
• The introduction of public sector
charges

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Komplikasi persalinan

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Health seeking behavior pattern
(Koenig et al, 2007)

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 HIV, STI

The very „social‟ nature of

the spread of HIV, and the
reflection of cultural beliefs
around sexuality, virility and
reproduction

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 HIV, STI
• Prevention through community
education
• Stigma reduction: preparation of
staff
• Comparable services: management
• Follow up of cases

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Barriers-determinants

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 Process – pathway of seeking
– traditional healers,
– village homeopaths, or untrained
allopathic doctors
– formally trained practitioners
– government health facilities
(Ahmed et al, 2001).

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• drawing out the factors which enable or
prevent people from making „healthy
choices‟, in either their lifestyle
behaviours or their use of medical care
and treatment.
• behaviour is best understood in terms of
an individual‟s perception of their social
environment.
• Model: Health belief model, social
cognition model
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Basic Components of The Health Belief Model
(Rosenstock, 1990, cited in Simon-Morton, Green & Gottlieb, 1995)

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Social cognition model

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 Perubahan perilaku:
Teori kognitif sosial
Self management:
 Self observation
 Self judgment
 Self reaction
Modelling:
 Diberi contoh perilaku
 Menggunakan tokoh panutan/idola 
profesional kesehatan sebaiknya
mengaplikasikan perilaku sehat
Skill training:
 Diberikan latihan keterampilan
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 But
• These only based on individuals

• KABP model not always work

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 MacPhail and Campbell (2001)
• begin to explore the neglected
societal, normative and cultural
contexts in which individual-level
phenomena such as knowledge,
attitudes and behaviour are
negotiated or constructed.

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 Bedri (2001)
• Health seeking behaviour clearly varies
for the same individuals or communities
when faced with different illnesses.

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 Tahapan Perubahan Perilaku transtheoretical
theory
(Simon-Morton, Greene & Gottlieb, 1995)
Tahapan Pendekatan Intervensinya
Prekontemplasi Informasi terkini, komunikasi persuasif,
pengalaman
Kontemplasi Informasi, komunikasi persuasif, pengalaman

Persiapan Cara untuk melakukan perubahan,

pengembangan keterampilan, perubahan sikap

Aksi Keterampilan untuk mempertahankan perilaku

yang sudah diubah, penguatan, dukungan,
manajemen diri, perubahan sikap

Mempertahankan Keterampilan pencegahan kekambuhan,

manajemen diri, dukungan sosial dan
lingkungan
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