Table 4 Factors determining health-seeking preferences among worksite workers and villagers
Descriptions | Similarities | Differences |
|---|---|---|
Local and traditional belief | ||
Local belief that taking traditional/local medicine and herbs and doing traditional practices (e.g., “Makalaung”—an action of piercing fingertips and toe tips with needle) would certainly relieve fever prior to or together with western medicine. Some also seek treatment from shaman due to spiritual and traditional belief | Traditional belief and local routine health practices influenced both residents and migrants to take such traditional means as the most commonly reported initial treatment option | These methods were quite more common among villagers. Despite these methods not being popular among migrants at first, the locals persuaded them to espouse such practices from them |
Easy availability | ||
Easy availability of traditional or western medicine at home or nearby drug stores encouraged self-medication and made convenient to take medicine on their own. Self-treatment involved taking medicine themselves or cocktail drugs purchased from nearby drug stores. The medicine they most often used were analgesics (such as Decolgen, paracetamol, Neomixagrip), traditional drugs (e.g., Shan drug power) and cocktail unspecified drugs | Self-treatment served as the popular choice for both villagers and worksite workers as one of the initial treatment options | No difference |
Arrangement by worksites | ||
Providing a medical box with western and traditional medicine for symptomatic relief at most of the worksites promoted workers to choose as the initial treatment Some worksites planned for their workers to seek health services at social welfare health centres without any charges Also, some worksite owners arranged transportation for their staff to seek health care at the formal health care services | No similarity | All these mentioned services only available at some worksites. From a medical box, the staff who administered drugs did not have any medical-related certificates No medical box available at village |
Local recommendation | ||
The word-of-mouth recommendation by neighbours determined choice on health service providers, which may be either informal providers, basic health staff, medical doctors or community health providers | In some instances, workers and villagers directly seek health care at health service providers without taking any prior self-medication | No difference |
Service cost | ||
Low cost to purchase medicine on their own Received treatment from informal providers and basic health staff by credit payment, which means that patients could pay service charges later, by the time patients could afford or after seasonal harvesting period | Low cost to buy medicine at drug store encouraged self-medication among all locals and workers rather than seeking care at health providers | Credit payment was more common among villagers despite being available for both |
Accessibility | ||
Nearby health service providers or drug stores Home health services by informal providers and basic health staff Accessible to malaria testing and treatment services via community health service volunteers | Nearby drug stores and home service by informal providers and basic health staff gave an access to health services among locals and migrants | Most migrants sought care from basic health staff nearby Some villages had the trained community volunteers who could provide malaria services to villagers, but very few worksites’ representatives reported volunteer services |
Trust and relationship | ||
Quality of services, prior good relationships and friendly nature of health services providers influenced care receivers to choose one of health care providers (either basic health staff or informal providers or medical doctors) Trust on the medical proficiency was one of the determinants in selecting formal health care providers No communication barriers | All the mentioned reasons were important for both locals and migrant workers in selecting health service providers Both migrants and locals preferred formal health care by medical doctors and basic health staff due to trust on medical proficiency | Migrant workers chose formal health service providers (medical doctors or basic health staff) who had no language barriers with them whereas locals favored informal providers and local health staff owing to being friendly and able to speak local Shan languages |
Disease severity | ||
Seeking health care services at the formal health centres and/or public hospitals happened at the conditions when symptoms became worsen and severe symptoms of disease not cured by initial treatment | Mostly, both locals and migrants chose the formal health centres or hospitals for their secondary source of health care | No difference |