Saudi authorities provide free 24 hour health services for hajjis through primary health care services and hospitals to ensure a safe and healthy environment during Hajj period. A variety of factors may cause poor utilization of health care services like poor socio-economic status, low education level, cultural beliefs and practices which affect awareness and recognition of severity of illness. Other factors that cause poor utilization of health care services are related to health care system itself such as lack of physical accessibility, language barrier with staff, lack of the required medicines, or dissatisfaction with the health services. So, this work aims at identifying factors affecting primary health care services (PHCS) utilization by international hajjis.
Methodology
A cross-sectional survey was conducted among international hajjis while staying in Mina using a self-administered questionnaire. Four nationalities were identified as the target population of this study; Egyptians, Pakistanis, Indonesians and Turkish. Sampling was done by stratified random cluster sampling technique. The questionnaire was translated to the languages of mentioned nationalities.
Results
Out of 600 respondents, 55.3% were males. Age group 41-60 years represented the majority (60.7%), and 84.6% were performing Hajj for the first time, 30.8% were suffering from a chronic disease, 54.9% knowing the place of the nearest primary health care centers, 35.9% knew the exact opening hours of PHCC (24 hours),and 39.4% had health service in their camp. Visiting PHCC was higher among Pakistanis (21.1%) followed by Egyptians as compared to Turkish and Indonesians. Out of those who didn't visit PHCC, 60.3% because they didn't become sick, 16.7% because they have medical service in their camp, 16.7% because they can't recognize PHCC locations, and 14.0% due to language barrier. Fear of language barrier was lower among Egyptians compared to other nationalities. Among the studied hajjis; females used PHCS more frequently than males. Hajjis with chronic illness were found to use PHCS at a higher rate than hajjis not having chronic illness. Hajjis with moderate to severe illness used PHCS more frequently than hajjis who had mild illness.
Conclusion
Visiting PHCC was higher among Pakistanis followed by Egyptians as compared to Turkish and Indonesians. The result of this difference is their knowledge about the place and opening hours of PHCC. Also, the distance from their camps to the nearest center was relatively shorter than that for Indonesians and Turkish in addition to the availability of health service in camps of Indonesians and Turkish. It was also noted that the severity of the disease, gender, and presence of chronic diseases can affect PHCC services utilization by international hajjis.