Correlates of Health Care Seeking Behavior among People Who Inject Drugs in Dar Es Salaam, Tanzania

Highlights

• We interviewed people who inject drugs in Dar es Salaam, Tanzania.
• Many people who inject drugs do not seek needed healthcare.
• Being employed improves healthcare-seeking behavior.
• Knowing where to seek affordable care improves healthcare-seeking behavior.
• Providing both health education and income-generating skills is crucial.

Background

People who inject drugs (PWID) suffer from a high burden of infectious disease. At the same time, they often have poor access to health care. As in other East African countries, the population of PWID is growing in Tanzania, but little is known about their contact with health care services. In this paper we examine patterns of health care use among PWID in Dar es Salaam and identify what factors are associated with regular contact with clinicians during illness.

Methods

We conducted a baseline cross-sectional study as part of a prospective cohort study involving PWID. We recruited 578 PWID, of whom 273 were newly enrolled on an integrated methadone-assisted treatment (MAT) program and 305 were community-recruited. At baseline, we interviewed the MAT program enrollees before they received services at the program clinics. We used bivariate and multiple logistic regression analyses to identify the factors associated with seeking medical care when ill.

Results

Only 25.4% of 578 participants reported seeing clinicians regularly when they needed medical care. Participants were more likely to see clinicians regularly if they were employed, (OR: 2.25, 95% CI: 1.28–3.98), had higher income levels (OR: 1.10, 95% CI: 1.00–1.22), were parents (OR: 1.71, 95% CI: 1.09–2.68), or knew where to seek affordable care (OR: 3.42, 95% CI: 2.12–5.52).

Conclusion

PWID in Dar es Salaam generally did not seek health care when needed. To improve their health care seeking behavior, it is important to advise PWID about where to seek affordable health care and to increase their income-generating skills.

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By:   Linda Beatrice Mlunde, Bruno Fokas Sunguya, Jessie Kazeni Kilonzo Mbwambo, Omary Said Ubuguyu, Akira Shibanuma, Junko Yasuoka, Masamine Jimba

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

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