People’s Perception of Their Health Status Assessment and Notion of Illness in Rural Bangladesh

Bangladesh, a densely populated developing country experiences geographic maldistribution of human resources for health services. Moreover, poor health expenditure and lack of knowledge on comprehensive health measurements are another vital issues to have a suitable health assessment system yet. The contemporary single global question of self-rated health measurement requires certain educational qualification to understand the depth and dimension of that question-which often misleads the actual assessment of health. This study's aim was to explore rural peoples’ perceptions of their own health and disease with an attempt to add few relevant and comparative questions along with that single global subjective question to measure health in rural community. Without questioning the importance of objective measures to assess health we gave more emphasis on subjective measures considering our country’s socio-economic, educational and health service resources. This was an explorative qualitative study using in-depth interviews and focus group discussion which was then thematically analyzed. Data were collected from three different villages in a district of Bangladesh. Regarding defining the theme of health although the study participants have uttered the word mental or psychological satisfaction, for the vast majority, health means physical health and they also consider disease as an obvious part of life. To combat disease or for being healthy majority preferred to take medicines. About majority of the study participants have some ideas about health assessment. Most of them considered subjective measures should be used to assess health and disease as it is quick and inexpensive and the majority of them were not interested to visit doctors as they prescribed objective measures. Within the subjective measures, they prefer a collective approach of using a few questions which should be easy to understand as well as not too long or even not too short like a single question. After a detailed discussion with the collective approach reported bad health boosted 23% to 47%. On the other hand, reported good health declined from 77% to 53%. Considering gender females are more cautious about both for their own and families' health than males. The majority of the participants expressed their uncertainty of health condition for upcoming years and most of them rely on the creator’s will. To identify the most vulnerable people or people’s health perception needs to add few collective questions along with the global single question to understand the actual scenario in developing countries like Bangladesh. Within very minimum resources this quick and easy collective subjective health measure tool might easily be used on a large scale to identify the most vulnerable group in the community to provide further support.