Health Seeking Behaviour Among Rural-Urban Migrant Slum Dwellers At Madina In The Greater Accra Region

ABSTRACT Rapid urbanisation, largely due to rural-urban migration, has not only led to increased city slums but has also led to an increase in health related challenges for the rural-urban migrant slum dweller. Health seeking behaviour among these sub-populations can only be achieved when policies designed take contextual issues into consideration. Although, considerable amount of research on the health seeking behaviour of slum dwellers exist, studies on the contextual exploration of rural- urban migrant slum settlements are relatively few. This study aims to investigate health seeking behavior among rural-urban migrant slum dwellers at Madina. The Health Belief Model (HBM), which is health specific behavioural cognitive model (Taylor et al., 2006; Orji et al 2012), was adopted and modified to help understand the health seeking behavior among rural- urban migrant slum dwellers, and how interventions by health planners can be achieved in slum settings such as the case of Madina in the Greater Accra Region. The conceptual framework suggests that to avoid a mismatch between context environments and health programmme interventions, there is the need for planners i.e. government and other stakeholders engaged in health programme interventions, to carry out a contextual exploration of specific environment situation to be able to know the exact health seeking behaviour patterns of the specific slum communities in order to formulate need based policies that lead to expected lifestyle behaviours. The study adopted the mixed method research design approach. Questionnaire and interview guides were used to collect data from rural-urban migrant households through the simple random technique and purposive sampling respectively. A total of 241 questionnaires were retrieved from the respondents representing a response rate of 100%. Eight (8) key informants and health officials were interviewed. The findings of the study show that various diseases in the slum were attributed to poor housing units and work conditions. However, few cases or no cases of disease attack were reported at places of origin. The study also found that health seeking behaviour was observed at various places of origin as compared to the slum. Additionally, the study indicates that though there were a few challenges in health seeking behaviour before migration, these challenges were more pronounced in the slums. The financial constraints in accessing health care compelled them to resort to various coping strategies to overcome their health challenges in the slum. The study also highlighted the absence of a policy to promote health seeking behaviour. Hence, policy responses were raised to help address the challenges of health seeking behaviour, key among them is the need to embark on health education programmes both at places of origin and the slum.