Exploring Self-Reported Morbidity, Health-Seeking Behavior and Associated Factors in Ethiopia: Evidence from National Health Equity Survey 2022/2023

Introduction Self-report is one of the easiest, cheapest and most widely used methods of collecting data about individuals’ health and risk factor status. Many health studies use self-reported data to assess the prevalence of given risk factors or health behaviors in the community. The objective of this study was to determine the level of perceived morbidity, treatment seeking behavior and associated factors using nationally representative self-reported morbidity data. Methods This study was embedded from a community based, national representative survey which was conducted from September 27 and December 20, 2022 in ten regions and two city administrations. Data collection in the eleventh region, i.e., Tigray region, was carried out separately from December 28, 2023 to February 14, 2024, due to contextual constraints. The survey covered 441 enumeration areas within 11 regional states and two city administrations. A two-stage stratified cluster sampling was employed to select the eligible households and a total of 9,157 household were selected. Data were collected through face-to-face interview with structured questionnaires. Descriptive statistics such as frequency with percentages and mean with standard deviations were employed to describe participants’ characteristics. Bivariate analysis was conducted to assess the association between treatment seeking behavior and independent variables. Mixed effects logistic regression was employed to determine predictors of treatment seeking behavior. Results A total of 2030 (18.02%) household heads experienced at least one perceived morbidity in the past 12 months prior to the survey date. Of these, 776(16.21%) were urban and 1254(18.71%) were rural residents. About 1793(89.4% with 95%CI: 3.76, 3.80) sought treatment to their perceived morbidity. In the multivariable analysis, Afar (AOR=0.47; 95%CI: 0.35, 0.64), Amhara(AOR=0.45; 95%CI: 0.33, 0.61), Oromia(AOR=0.26; 95%CI:0.18, 0.38), Ethiopia Somali(AOR=0.31; 95%CI: 0.21, 0.46), Benishangul-Gumuz (AOR=0.13; 95%CI: 0.09, 0.19), SNNPR(AOR=0.51; 95%CI: 0.37, 0.70), Sidama(AOR=0.59; 95%CI: 0.40, 0.87), South west-Ethiopia(AOR=0.23; 95%CI: 15, 35), Harari(AOR=0.29; 95%CI: 19, 45), and Dire Dawa(AOR=0.80; 95%CI: 0.53, 1.00) were found to be less likely to seek treatment to their perceived morbidity compared to Tigray regional state while Gambela was 2.7 (95%CI:2.07, 3.63) times more likely to seek treatment compared to Tigray regional state. Other factors associated with treatment seeking behavior were being male (AOR, 1.2; 95%CI: 1.00, 1.37), own agricultural land (AOR=1.6; 95%CI: 1.37, 1.80), safety net beneficiaries (AOR=1.5; 95%CI: 1.27, 1.86), self-rated health status (very poor, AOR=2.4; 95%CI: 1.53, 3.90; poor, AOR=5.6; 95%CI: 4.28, 7.44; Neutral, AOR=2.9; 95%CI: 2.21, 3.68; Good, AOR=1.9; 95%CI: 1.55, 2.40) showed statistically significant association. Conclusion This study revealed that majority of the participants sought treatment from health facility for their perceived illness. However, there were significant disparities across the regions and participant characteristics. Thus, the study finding underscores the need for targeted interventions to address inequalities and identified barriers to enhance equitable health care utilization across the regions.