Challenges and Patterns of Seeking Primary Health Care in Slums of Karachi: A Disaster Lurking in Urban Shadows

Abstract

This study aimed to evaluate the challenges and patterns of seeking primary health care services in slums of Karachi, where about 60% of the population lives in various informal settlements. We surveyed 8 largest slums of the metropolitan, and analyzed the data both descriptively and inferentially to evaluate the factors associated with health care seeking behavior. Significantly positive association of quality health care seeking behavior and various socioeconomic indicators were found. In addition, substantial insights about the conditions of slum dwellers and health challenges of the population, such as low immunization and low vaccinations, among others, were reported. Thus, the role of policymakers is emphasized to strategize for the inclusion of these people in national health plans and to develop health infrastructure near these communities. Furthermore, there is a strong need to increase awareness of the population about hygiene practices, importance of immunization, and importance of utilizing appropriate health care services.

The Effect of Sustainable Urban Planning and Slum Disamenity on The Value of Neighboring Residential Property: Application of The Hedonic Pricing Model in Rent Price Appraisal

“…While world leaders and famous consultancy firms well-planned Islamabad before its construction, Doxiadis Associates was consulted in the 1960s, before executing the final master plan of Islamabad city [14]. At present, the capital city, Islamabad, offers state-of-the-art urbane real estate infrastructure, and the elite individuals across the country prefer to settle in this modern city, as they can enjoy current infrastructure, better security, surrounding natural sights, a better environment, and other additional facilities associated with a better quality of life [1,15,16] (See Figure 1). world's societal and environmental qualities are vital for people, as such factors unswervingly influence people's day-to-day life [5,6].…”

For Better Quality and More Integrated Primary Health Care Services through Harnessing the Private Sector in Sindh Province

“…6 A study by Aleemi et al in urban Sindh found that 32% of participants relied on a Daii (midwife) for obstetric care; a spiritual healer (32.6%), and a Hakeem (practitioners of traditional medicines most often distributing potions; 11.4%), mostly for general treatments. 18 An outreach primary service package is also delivered through the Lady Health Workers from the public sector, whilst some private sector organizations have outreach models operating on voluntary, community workforce, franchise, and home-based care models. 18 Although the private sector is the dominant provider of basic health care in urban areas, these services vary in quality and with often limited preventive and health promotion services, and access for the poor.…”

“…18 An outreach primary service package is also delivered through the Lady Health Workers from the public sector, whilst some private sector organizations have outreach models operating on voluntary, community workforce, franchise, and home-based care models. 18 Although the private sector is the dominant provider of basic health care in urban areas, these services vary in quality and with often limited preventive and health promotion services, and access for the poor. The Pakistan Social and Living Standards Measurement Survey (2014-15) observed that in the majority of districts of Punjab and Sindh, women seek consultations for antenatal care and postnatal care from private hospital/clinics.…”

“…Upon further investigation into the reasons for not utilizing formal health care facilities, Aleemi et al found that easy access (29%); lower costs (24%); and waiting timings, (13.7%), were the main reasons for seeking care from the formal and informal private sector. 18 Currently, there is a need to increase consumer awareness and, whilst a consumer protection policy exists in Sindh, this needs to be reinforced. Institutions such as the Agha Khan University (Urban Health Programme) and franchises including Greenstar, conduct social and behavior change communication activities within their private network clinics.…”

Advancing universal health coverage in South Asian cities: a framework

“…This is especially true for the urban poor, who lack the health literacy, time, and social and financial resources necessary for optimal care seeking 21. The challenges are well known—poor infrastructure, uncoordinated and fragmented health service delivery, suboptimal financing, insufficient coordination among multiple agencies, dynamic and heterogeneous population needs, and weak public primary care capacity 22.…”