Intervention strategies to promote health-seeking behaviour among men in rural villages of selected Districts in Limpopo Province, South Africa.
Background: In many societies, few men utilise the available health care service and those who seek care are likely to discontinue care before completing treatment. Men’s utilisation of health services remains low and tests for Human immunodeficiency virus (HIV) have even lower number, compared to women. They spend a long duration infected by untreated diseases such as STIs and have an increased chance of HIV infection, become severely ill, and die from the diseases. South Africa is among the countries where men utilise health care services at a lower number compared to women. Aim: This study sought to develop intervention strategies to promote health-seeking behaviour among men in rural villages of selected Districts in Limpopo Province, South Africa. The objectives were to: Describe Behavioural, socio-economic, cultural, and environmental factors that contribute to men’s poor health-seeking behaviour; Explore health system factors that contribute to low utilisation of health services and poor health-seeking behaviour; Describe the views of men on their health; Explore strategies that may encourage men to utilise health services; Assess knowledge of men on their health and determine their attitude towards public health care services; Validate the developed strategies. Methods: This study was conducted in multiphase. In the first phase, A systematic review was conducted. The second phase focused on convergent parallel mixed methods design comprising both qualitative and quantitative methods. The findings from both qualitative and quantitative were then merged side by side. Purposively selected participants for the qualitative strand were interviewed using both individual interviews and focus group discussions based on their categories. Randomly selected participants for the quantitative strand were given a self-administered questionnaire to complete to collect data from them. The qualitative data was analysed using Tesch’s eight steps, while the Statistical Package for Social Sciences (SPSS), version 29.0 was used to analyse quantitative data by employing descriptive and inferential statistics. Phase three focused on developing strategies and validating developed strategies. The Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, was applied to the findings from phase two. Build, Overcome, Explore and Minimise (BOEM) models, were then applied to the outcomes of the SWOT analysis and used to develop strategies. Chinn and Kramer's evaluation theory was used to validate developed strategies. Validity and reliability were ensured for quantitative findings, while the trustworthiness of qualitative findings was established through credibility, dependability, transferability, and conformability measures. Ethical considerations were observed. Results: The systematic review found that peer education, Men’s Sheds, HIV self-testing, and Telemedicine and digital platforms were among the strategies that have been used in other countries to improve men’s health-seeking behaviours. The qualitative inquiry identified factors that contribute to men’s poor health-seeking behaviours and experiences of men when visiting public health facilities. Through quantitative inquiry, men’s knowledge of their health was assessed and their attitudes towards public health services were determined. A total of 14 strategies were developed and this included the introduction of male-dedicated sections in existing health facilities: implementation of community outreach campaigns targeting males, providing male-dedicated health services through telemedicine, employing male nurses and community health workers (CWHs), regular staff training of health professionals serving males, and reducing the waiting period for males in the health facilities. Validation led to a few adjustments in the strategies suggested by experts. All Stakeholders agreed with the proposed strategies. Amendments to the strategies were made and presented based on the suggestions. Conclusion: Men are more likely to experience poor health outcomes due to poor health-seeking behaviour. There is a need to address men’s poor health-seeking behaviour in the Limpopo province. Implementing the proposed strategies could help improve men’s health-seeking behaviour in Limpopo province and improve health outcomes among men. The strategies should be implemented in the study setting, monitored, and evaluated to measure their impact. If the strategies lead to a positive impact on men’s health-seeking behaviour, they can then be extended to other settings.
Health care, Health-seeking behaviour, Intervention, Limpopo, SOCIAL SCIENCES::Social sciences::Psychology::Environmental psychology, Strategies, UCTD
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