Health seeking pathways for stroke survivors in a rural setting: Optimising early intervention for stroke rehabilitation in occupational therapy

Abstract

Background: Health seeking behaviour and health seeking pathways are interdependent concepts underpinning access

to healthcare. Understanding these concepts is critical for appropriate and time-dependant stroke interventions. Method: An explorative qualitative study design using one-on-one semi-structured interviews were conducted with 16 participants who were either stroke survivors or caregivers of stroke survivors. The Socio-Ecological Model (SEM) was used to guide data collection and the discussion of the findings in line with the objectives of this study.

Findings: The traditional health practitioners (n=11) were the most preferred first encounter followed by public hospital (n = 2) and private hospital (n=1) while others (n=2) self-medicated. On average, it took 30 days for stroke survivors to navigate the health system. The two themes emerging from this study, were ‘health seeking delays’, and ‘the health seeking behaviour factor’.

Conclusions: A combination of factors influenced the health seeking delays at the levels of the SEM. The participants’ health seeking behaviours were influenced by their knowledge, attitude, and beliefs at individual and interpersonal levels as well as dissatisfaction with health services at organizational and public policy levels of the SEM. In the South African rural settings, stroke survivors seek medical help from multiple service providers prior to consulting the public healthcare system due to diverse factors that affect them at interpersonal organizational, community and policy levels.