Factors Influencing Health-Seeking Behavior Among Sudanese Expatriates in Saudi Arabia, 2023. A Cross-Sectional Study

Factors Influencing Health-Seeking Behavior Among Sudanese Expatriates in Saudi Arabia, 2023. 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A Cross-Sectional Study Noor Salaheldin Humaida Elfaki, Hafeia Abdelrazig Elhussien Abdelgyoum This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3848931/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background Immigrant groups face prejudice and have limited access to healthcare. In Saudi Arabia, expatriates are particularly socially disadvantaged. Saudi Arabia has taken the lead in drawing enormous numbers of Sudanese professionals and technical labor throughout the years and is becoming an increasingly preferred destination after the Sudanese War of April 15, 2023. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia, as understanding these factors is important for improving healthcare access and health outcomes. Method A cross-sectional study was conducted targeting Sudanese residents of KSA via convenient sampling. A self-administered questionnaire was distributed electronically and 494 participants were recruited for the study. Results This study showed that the majority of the participants (66.6%) visited a primary healthcare center when faced with a medical problem. However, the prevalence of self-medication in the past three months was 45.7%. Only age (OR [95% CI]: 1.032 [1.000-1.066]) and not having health insurance were found to significantly influence health-seeking behavior. Conclusions This study emphasizes the importance of understanding healthcare-seeking behavior among immigrant groups, particularly Sudanese expats in Saudi Arabia. It highlights the significance of insurance as a determinant of healthcare-seeking behavior and calls for reforming current policies to reduce disparities in accessing healthcare services. Health-seeking behavior Healthcare-seeking behavior Factors influencing health-seeking behavior Sudanese expatriates Saudi Arabia Health insurance Background Health-seeking behavior (HSB) is described as any action or inaction undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate remedy .( 1 ) Health-seeking behavior is initiated by a decision-making process that is influenced by individual and/or familial behavior, community standards and norms, and provider-related features and behavior. ( 2 ) Various studies show that socioeconomic status, sex, age, social standing, type of disease, access to resources, and perceived quality of care all influence the decision to engage with a specific medical channel. ( 3 , 4 ) This behavior, on an aggregate and global scale, has the potential to organize and strongly influence the demand for healthcare services. ( 5 ) It is conceptualized that access to and use of treatment services is a public right. Studies suggest that there is a positive relationship between the availability and quality of health services and their utilization, i.e., health-seeking behavior( 6 – 9 ) nevertheless, some inequalities in access to these services have been observed, indicating that patients from lower social and economic positions, as well as certain nationalities and minority groups, benefit less from these advantages.( 10 ) According to recent International Organization of Migration (IOM) estimations, there were approximately 281 million international migrants worldwide in 2020( 11 ) whose lives were influenced by social factors in their home countries and who were confronted with new social, economic, and political conditions in the nations where they migrated. In particular, labor migration has been linked to high stress levels, poor working conditions, and poor psychological and physical health. ( 12 ) Moreover, there is consistent evidence from several sources indicating that immigrant groups face prejudice and have limited access to healthcare. Available data from Arab Gulf countries in particular show that the expatriate community has less access to healthcare. ( 13 ) In Saudi Arabia, expatriates are particularly socially disadvantaged because of their low average income and lack of knowledge of how they can utilize the necessary resources. ( 14 ) The International Organization of Migration classifies Sudan as a country with active migration movements both internationally and internally. ( 15 ) Sudanese migration may be influenced by a variety of factors, including the economy, political instability, military repression, improved working conditions in host countries, a lack of economic possibilities in Sudan, and personal reasons. ( 16 ) With the ongoing war in Sudan, it is estimated by the IOM that “over 1 million people have been reported fleeing Sudan into neighboring countries, and if the conflict continues, it is estimated that almost 2 million refugees and migrants will be affected by the crisis”.( 17 ) In recent times, Sudanese migrants have primarily sought asylum in the oil-rich Gulf Arab countries. ( 16 ) Ought to its geographical proximity to Sudan, the Kingdom of Saudi Arabia (KSA) has taken the lead in drawing large numbers of Sudanese professionals and technical labor. Similarly, their past economic and social ties played a crucial role in facilitating migration. ( 15 ) According to official census data, there are 819,600 Sudanese migrants in the Kingdom, constituting 6.1% of the migrant population (which comprises 41.6% of the total population). ( 18 ) Sudanese immigrants face unique challenges accessing healthcare in Saudi Arabia. Cultural differences and lack of knowledge about the healthcare system are some of the barriers that can prevent them from seeking medical care. Most studies on immigrant health have focused on Western countries,( 19 ) and there is a need to understand the unique challenges faced by immigrants in non-Western contexts. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia. Understanding these factors is important for improving access to healthcare and health outcomes for this population. This research contributes to filling a knowledge gap and can inform the development of culturally appropriate interventions to improve healthcare access for Sudanese immigrants in Saudi Arabia. Methods 3.1 Study Design and Population A community-based cross-sectional study was conducted using an online population survey. Participants were recruited using convenient sampling. We included any Sudanese immigrants residing in KSA at the time of the study, males and females aged 18 years or older. A total of 530 responses were collected during the study period, from the 1st of August to the 1st of September 2023. After processing and excluding visitors (individuals who recently came to KSA with a visiting visa), 494 participants were recruited for the study. 3.2 Data collection tools A self-administered questionnaire was constructed in Arabic using Google Forms and then revised by two public health experts. Additionally, 30 participants were piloted, and appropriate adjustments were made. The questionnaire consisted of two parts: the first recorded demographic information and the length of residency in the KSA. The second assessed the participants’ health-seeking behavior and consisted of four questions. The first was to evaluate the first action taken after encountering a health problem, and the other three were to evaluate self-medication behavior. 3.3 Data collection method A self-administered questionnaire was distributed electronically through Sudanese social groups on social media (Facebook and WhatsApp), as this made it easier to circulate the questionnaire among the desired population. Measurements were made to ensure a representative sample, including distributing the survey through multiple groups with different demographics in terms of age, sex, and occupation. 3.4 Data analysis For descriptive statistics, the data were coded and examined using SPSS (version 26.0). For the data analysis, descriptive statistics, such as frequencies and percentages, were calculated. Chi-square analysis was performed to determine any correlations between respondents' sociodemographic information and their health-seeking behavior. Additionally, logistic regression was used to forecast the elements that significantly influenced how people sought medical care. A 95% confidence interval and a P value of 0.05 were considered significant. Results During the study period, 494 participants were recruited. They were predominantly males (86.6%), with a mean age of 36.5 years (+/- 9.25 years). Most of them worked in the private sector (71.7%) and had an average monthly income of 4467 SRs (+/- 4097 SRs). Half of the respondents had no insurance or had informal insurance (44.1%). Only 20.3% reported having a chronic disease, with hypertension (10.5%) or diabetes mellitus (7.9%) being the most common. Table 1 Table 1 Demographic characteristics of the studied population Characteristic Divisions Frequency Percentage Age 50-year-old 51 10.3 Gender Male 428 86.6 Female 66 13.4 Marital status Single 162 32.8 Married 322 65.2 Divorces, separated or widowed 10 2.0 Highest educational level Primary or secondary education 74 15.0 Diploma or Bachelor's degree 328 66.4 Higher studies 92 18.6 Occupation Government sector employee 25 5.1 Private sector employee 354 71.7 Nonskilled worker or crafts maker 64 13.0 Housewife 18 3.6 Student 7 1.4 Unemployed or retired 25 5.1 Monthly Income in SR 0-2000 134 27.1 2000–5000 235 47.6 5000-10,000 89 18.0 10,000–30,000 27 5.5 Duration of residency 10 years 172 34.8 Chronic diseases Yes 103 20.9 No 391 79.1 Health insurance status No insurance 116 23.5 Informal insurance 100 20.2 Silver insurance (30K SR) 97 19.6 Gold insurance (50K SR) 47 9.5 Platinum insurance (100K SR) 35 7.1 Diamond insurance (250K SR) 20 4.00 C insurance (500K SR) 73 14.8 Total 494 100 Table 2 shows the first action taken by the respondents when they were faced with health issues. The majority of respondents claimed that they would go directly to primary health care (PHC), while only 3.4% reported that they would take a drug without a prescription. A total of 11.3% said they would self-diagnose themselves using the internet, 10.7% claimed they would consult an acquainted doctor, and only 7.9% said they would consult a pharmacist. Table 2 First action taken after encountering a health issue First Action Frequency Percent Go to a hospital or PHC 329 66.6 Consult a doctor from my acquaintances 53 10.7 Go to the pharmacy and consult the pharmacist 39 7.9 Try to diagnose and treat myself using the internet 56 11.3 Go and buy drugs directly without consultation 17 3.4 Total 494 100.0 Approximately half of the respondents denied taking any drugs without a doctor's prescription in the last 3 months (54.3%). Of the other half, 21.5% took it only once, 10.1% took it twice, 5.5% took it three times and 8.7% reported taking drugs without a prescription more than 3 times in the last three months. Moreover, 63.8% of the participants claimed they took drugs based on a doctor’s order, in addition to previous experience (45.5%), advice from friends or relatives (16.2%), and information found on the internet (21.2%), as shown in Tables 3 and 4 . Table 3 Number of times drugs were taken without a doctor’s prescription in the last three months frequency percentage None 268 54.3 Once 106 21.5 Twice 50 10.1 Three times 27 5.5 More than three times 43 8.7 Total 494 100.0 Table 4 Basis for taking drugs in the last three months Frequency Percentage Doctor’s orders Yes 315 63.8 No 179 36.2 Previous experience Yes 225 45.5 No 269 54.5 Friend or relative advice Yes 80 16.2 No 414 83.8 Information on the internet Yes 104 21.1 No 390 78.9 Total 494 100 The variables that were significantly associated with health-seeking behaviors according to the chi-square test of independence included age (χ2 (4, n = 494) = 16.148, p = .003), marital status [χ2 (1, n = 494) = 11.657, p = .001], duration of residency in Saudi Arabia [χ2 (3, n = 494) = 18.956, p < .001] and health insurance status [χ2 (6, n = 488) = 23.382, p = .001]. However, we found no significant associations between health-seeking behavior and sex, occupation, monthly income, level of education, or the presence of a chronic disease, as shown in Table 5 . Table 5 Association between sociodemographic factors and positive health-seeking behavior Positive health-seeking behavior X2 value P value Yes No Age 18–24 9 7 16.148 0.003 25–34 135 94 35–44 104 44 45–54 53 15 55–65 27 5 gender Female 48 18 1.286 0.257 Male 281 147 Marital Status Married 232 90 12.351 < 0.000 Single 97 75 Educational level Primary or secondary education 49 25 2.787 0.248 Diploma or bachelor degree 212 116 Higher studies 68 24 occupation Professional worker 258 122 1.246 0.536 Nonskilled worker or crafts maker 40 24 Unemployed, Housewife, Student, or Retired 31 19 Income 1 84 50 2.423 0.489 2 10 75 3 64 25 4 17 10 Duration of residency < 2 years 37 39 18.956 10 years 128 44 Chronic diseases Yes 75 28 2.261 0.133 No 254 137 Health insurance status No insurance 61 55 23.382 0.001 Informal insurance 62 38 Silver insurance (30K SR) 68 24 Gold insurance (50K SR) 39 8 Platinum insurance (100K SR) 28 7 Diamond insurance (250K SR) 17 3 C insurance (500K SR) 50 23 A logistic regression model was used to further understand the effect of these factors on health-seeking behavior. The model was statistically significant, χ2 (1 1, n = 494) = 42.820, p < 0.001. It explained 12.1% (Nagelkerke R2) of the variance in health-seeking behavior, and it correctly classified 69.4% of the cases. The Hosmer and Lameshow goodness of fit test showed a P value of 0.366. Out of the 4 variables we entered into the model, only age (OR [95% CI]: 1.032 [1.000-1.066]) and having no health insurance were found to be significant according to the model, as shown in Table 6 . The duration of residency and marital status were not significant. Table 6 Logistic regression model OR 95% CI P value Age 1.032 1.000–1.066 0.049 Marital status Single 1.00 Married 0.830 0.498–1.385 0.476 Health insurance No health insurance 1.00 0.019 Informal insurance 0.643 0.335–1.233 0.184 Silver insurance (30K SR) 0.877 0.446–1.723 0.703 Gold insurance (50K SR) 1.042 0.527–2.061 0.906 Platinum insurance (100K SR) 2.552 0.994–6.553 0.052 Diamond insurance (250K SR) 1.909 0.708–5.145 0.202 C insurance (500K SR) 2.486 0.634–9.747 0.192 Duration of residency in KSA Less than 2 years 1.00 0.390 Two to five years 1.326 0.715–2.458 0.370 Five to ten years 1.809 0.913–3.587 0.089 More than 10 years 1.640 0.802–3.354 0.175 Discussion To the best of our knowledge, this is the first study assessing the health-seeking behavior of Sudanese expats in Saudi Arabia. We define a positive HSB as going to a primary health-care institution when faced with a medical issue. We found a 66.6% rate of positive HSB. These results align with those of other studies performed in Malaysia (66.7%), Nigeria (63%) and India (74.6%). ( 20 – 22 ). We also aimed to analyze the associations between HSB and sociodemographic factors. Overall, we found that only insurance and age are significant factors. INSURANCE Prior research indicates that health insurance lowers the cost of hospital stays and medication, allowing people to receive better medical care while treating a variety of illnesses. ( 23 ) ( 24 )However, other research has demonstrated that insurance does not significantly increase the use of health services, particularly in situations where individuals still receive high-quality care even if they do not have insurance. ( 25 ) Nonetheless, the positive effect of insurance is more significant in marginalized populations. ( 26 ) This study revealed that there is a strong association between health insurance status and positive or negative health-seeking behavior. In this study, almost half of the participants (43.7%) had no or informal insurance. This percentage is higher than that demonstrated in a wider-scale study conducted on Saudi expats, which found that only 30% of expats were uninsured. ( 14 ) However, the latter study had very different demographics, with participants all being male and the majority being non-Arab workers, and with no mention of the number or the mere existence of Sudanese participants. Informal insurance is publicly considered a way for companies and employers to evade authorities without providing workers with actual health insurance coverage. According to Saudi Labor Law, employers must bear the responsibility for paying all necessary medical expenses for their expatriate employees ( 27 ), yet many expatriate workers and their families remain uninsured. The link between health insurance coverage and HSB was also demonstrated in a similar study conducted on Saudi and non-Saudi nationals in KSA. It was found that receiving health insurance increases the chances of attending a medical check-up by approximately 13% among Saudis, while it has a 20% increase in non-Saudis . ( 26 ) These results were also aligned with a qualitative study on low-income Bangladeshi migrant workers from the United Arab Emirates, in which the participants described insurance structures as barriers to achieving good health. ( 12 ) AGE The results of this study revealed a strong association between HSB and age, indicating that older participants were more likely to seek appropriate healthcare. This could be partially due to a greater sense of responsibility in elderly individuals and/or a greater incidence of chronic illness. A valid theory would also be that older Sudanese expats are most likely experts in their professions and have better access to higher categories of health insurance. This positive association was similarly described in a study in Senegal that found an increase in the odds of seeking healthcare among people older than 40 years, ( 28 ) contradicting the findings of another study conducted in Iran that revealed an inverse relationship between age and appropriate HSB, where older people were less likely to seek healthcare. ( 10 ) Monthly Income Although the association with insurance was significant, monthly income was not. This is contrary to the belief that better income will instantly mean better access to healthcare and affordability of health services. However, this finding aligns with that of another study that was conducted on both Saudi and non-Saudi people in Al-Ahsa, in which monthly income itself was not significant but rather how people perceived their economic status was. ( 29 ). We believe that the immigration status of our participants might have influenced these results; non-Saudis do not have access to free medical care in governmental facilities that Saudis receive. Therefore, expatriates treat their curative health problems either by insurance or, in the worst-case scenario, by out-of-pocket payments. ( 26 )Nonetheless, the average monthly income for Saudis is approximately 10,000 SR, and 94.5% of our participants had a monthly income below this average. In general, the average monthly income for non-Saudi workers is less than half that of Saudi people (4500 SR); this finding shows that the increase in monthly income for expats is too minimal to influence their healthcare decisions compared to insurance that grants them significantly cheaper healthcare services even in its lowest categories. Negative HSB Despite a relatively high percentage of positive HSB in our sample, 45.7% of the participants practiced self-medication without a doctor's prescription. This is a high percentage compared to that in other countries such as Malaysia (11.8%)( 20 ) but an extremely low percentage compared to that in Sudan. The percentage of self-medication in Sudan according to a recent study was 100%. ( 30 ) Another study that assessed self-medication with antibiotics reported 87% of the participants. ( 31 ) This highlights the importance of healthcare system affordability and health insurance in promoting positive HSB, in addition to strict regulations that prevent pharmacists from giving drugs without prescriptions. Unexpectedly, very few of our participants reported using the Internet as a source of health and treatment information. This finding does not align with the findings of other studies in KSA, which showed that 92.6% of their sample used social media as a source of medical information. ( 32 ) Despite the lack of significant research discussing the online HSB of the Sudanese population, we cannot disregard such a low rate. Although it protects against misinformation and self-medication, it cuts those Sudanese people off online health awareness campaigns and health education in general. Strength and limitations As the first paper to be written on the health-seeking behavior of Sudanese expats, our study provides a foundation for future research and programs aimed at improving the health status and healthcare access of Sudanese immigrants and refugees worldwide. With the ongoing war in Sudan leading to a surge in refugees, our findings are particularly relevant and timely. While our study sheds light on the health-seeking behavior of Sudanese expats, it is limited by its convenient sampling method, which may not accurately represent the larger population. Additionally, the low percentage of females in our sample calls for further research to explore the impact of gender on health-seeking behavior. Furthermore, our study focused on health-seeking behavior toward any illness or medical issue, which may not reflect the behavior toward specific illnesses that could be influenced by factors such as severity and duration. Conclusion Understanding the determinants of health-seeking behavior (HSB) among immigrant groups is crucial for improving healthcare access and resource allocation for this population. As inappropriate HSB has been linked to poorer health outcomes, identifying the factors that influence HSB can provide valuable insights into designing tailored health interventions to support the Sudanese expatriate community in Saudi Arabia. This study highlights the significance of insurance as a determinant of HSB, emphasizing the need for reforming current insurance policies that prioritize private companies over the health of expatriates. Further research is needed to explore the healthcare preferences and behaviors of Sudanese people and other expats, particularly women and young people, to develop targeted policies aimed at reducing socioeconomic disparities in accessing healthcare services. By promoting universal health coverage, these policies can contribute to achieving sustainable development goals and improving the overall health and well-being of immigrant populations. Abbreviations HSB Health-seeking behavior KSA Kingdom Saudi Arabia PHC Primary health care Declarations Ethical approval and consent to participate The study protocol was approved by two experts from the community medicine department at the University of Khartoum. The participants consented to participate in the study by signing an electronic consent form. The significance of the study and its goals were also conveyed. Individuals were made aware that participation in the study was optional and that they had the right to revoke consent at any time. Additionally, the confidentiality of the information gathered was emphasized. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. Funding The authors received no funding for the conceptualization, design, data collection, analysis, decision to publish, or preparation of this manuscript. Author contributions N.E. conceptualized the research idea and collected the data. H.A. reported the results and prepared the tables. H.A. and N.E. analyzed the data and wrote the main manuscript text. Both Authors reviewed the manuscript. 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The Use of Internet and Social Media for Health Information and Its Consequences Among the Population in Saudi Arabia. 2021;13(9). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 08 Apr, 2024 Reviews received at journal 03 Apr, 2024 Reviewers agreed at journal 29 Mar, 2024 Reviews received at journal 15 Mar, 2024 Reviewers agreed at journal 15 Mar, 2024 Reviewers agreed at journal 15 Mar, 2024 Reviewers invited by journal 16 Jan, 2024 Editor assigned by journal 16 Jan, 2024 Editor invited by journal 15 Jan, 2024 Submission checks completed at journal 15 Jan, 2024 First submitted to journal 09 Jan, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3848931","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267503337,"identity":"f9cf359f-44be-4f11-a562-e841e5e5c95d","order_by":0,"name":"Noor Salaheldin Humaida Elfaki","email":"","orcid":"","institution":"Faculty of Medicine, University of Khartoum","correspondingAuthor":false,"prefix":"","firstName":"Noor","middleName":"Salaheldin Humaida","lastName":"Elfaki","suffix":""},{"id":267503338,"identity":"cd867c34-6ff8-4b37-9f20-290c3e956b80","order_by":1,"name":"Hafeia Abdelrazig Elhussien Abdelgyoum","email":"data:image/png;base64,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","orcid":"","institution":"Faculty of Medicine, University of Khartoum","correspondingAuthor":true,"prefix":"","firstName":"Hafeia","middleName":"Abdelrazig Elhussien","lastName":"Abdelgyoum","suffix":""}],"badges":[],"createdAt":"2024-01-09 18:03:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3848931/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3848931/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49742207,"identity":"8b5bff02-369d-4e99-b547-4082a41f85fd","added_by":"auto","created_at":"2024-01-17 09:40:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":322147,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3848931/v1/2f3318bd-6400-4dfb-8a08-13804464a7dc.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors Influencing Health-Seeking Behavior Among Sudanese Expatriates in Saudi Arabia, 2023. A Cross-Sectional Study","fulltext":[{"header":"Background","content":"\u003cp\u003eHealth-seeking behavior (HSB) is described as \u003cem\u003eany action or inaction undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of finding an appropriate remedy\u003c/em\u003e.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) Health-seeking behavior is initiated by a decision-making process that is influenced by individual and/or familial behavior, community standards and norms, and provider-related features and behavior. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) Various studies show that socioeconomic status, sex, age, social standing, type of disease, access to resources, and perceived quality of care all influence the decision to engage with a specific medical channel. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) This behavior, on an aggregate and global scale, has the potential to organize and strongly influence the demand for healthcare services. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIt is conceptualized that access to and use of treatment services is a public right. Studies suggest that there is a positive relationship between the availability and quality of health services and their utilization, i.e., health-seeking behavior(\u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) nevertheless, some inequalities in access to these services have been observed, indicating that patients from lower social and economic positions, as well as certain nationalities and minority groups, benefit less from these advantages.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eAccording to recent International Organization of Migration (IOM) estimations, there were approximately 281\u0026nbsp;million international migrants worldwide in 2020(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) whose lives were influenced by social factors in their home countries and who were confronted with new social, economic, and political conditions in the nations where they migrated. In particular, labor migration has been linked to high stress levels, poor working conditions, and poor psychological and physical health. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) Moreover, there is consistent evidence from several sources indicating that immigrant groups face prejudice and have limited access to healthcare. Available data from Arab Gulf countries in particular show that the expatriate community has less access to healthcare. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) In Saudi Arabia, expatriates are particularly socially disadvantaged because of their low average income and lack of knowledge of how they can utilize the necessary resources. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThe International Organization of Migration classifies Sudan as a country with active migration movements both internationally and internally. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) Sudanese migration may be influenced by a variety of factors, including the economy, political instability, military repression, improved working conditions in host countries, a lack of economic possibilities in Sudan, and personal reasons. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) With the ongoing war in Sudan, it is estimated by the IOM that \u0026ldquo;over 1\u0026nbsp;million people have been reported fleeing Sudan into neighboring countries, and if the conflict continues, it is estimated that almost 2\u0026nbsp;million refugees and migrants will be affected by the crisis\u0026rdquo;.(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) In recent times, Sudanese migrants have primarily sought asylum in the oil-rich Gulf Arab countries. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) Ought to its geographical proximity to Sudan, the Kingdom of Saudi Arabia (KSA) has taken the lead in drawing large numbers of Sudanese professionals and technical labor. Similarly, their past economic and social ties played a crucial role in facilitating migration. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) According to official census data, there are 819,600 Sudanese migrants in the Kingdom, constituting 6.1% of the migrant population (which comprises 41.6% of the total population). (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eSudanese immigrants face unique challenges accessing healthcare in Saudi Arabia. Cultural differences and lack of knowledge about the healthcare system are some of the barriers that can prevent them from seeking medical care. Most studies on immigrant health have focused on Western countries,(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) and there is a need to understand the unique challenges faced by immigrants in non-Western contexts.\u003c/p\u003e \u003cp\u003eThis study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia. Understanding these factors is important for improving access to healthcare and health outcomes for this population. This research contributes to filling a knowledge gap and can inform the development of culturally appropriate interventions to improve healthcare access for Sudanese immigrants in Saudi Arabia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Study Design and Population\u003c/h2\u003e \u003cp\u003eA community-based cross-sectional study was conducted using an online population survey. Participants were recruited using convenient sampling. We included any Sudanese immigrants residing in KSA at the time of the study, males and females aged 18 years or older. A total of 530 responses were collected during the study period, from the 1st of August to the 1st of September 2023. After processing and excluding visitors (individuals who recently came to KSA with a visiting visa), 494 participants were recruited for the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Data collection tools\u003c/h2\u003e \u003cp\u003eA self-administered questionnaire was constructed in Arabic using Google Forms and then revised by two public health experts. Additionally, 30 participants were piloted, and appropriate adjustments were made. The questionnaire consisted of two parts: the first recorded demographic information and the length of residency in the KSA. The second assessed the participants\u0026rsquo; health-seeking behavior and consisted of four questions. The first was to evaluate the first action taken after encountering a health problem, and the other three were to evaluate self-medication behavior.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Data collection method\u003c/h2\u003e \u003cp\u003eA self-administered questionnaire was distributed electronically through Sudanese social groups on social media (Facebook and WhatsApp), as this made it easier to circulate the questionnaire among the desired population. Measurements were made to ensure a representative sample, including distributing the survey through multiple groups with different demographics in terms of age, sex, and occupation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Data analysis\u003c/h2\u003e \u003cp\u003eFor descriptive statistics, the data were coded and examined using SPSS (version 26.0). For the data analysis, descriptive statistics, such as frequencies and percentages, were calculated. Chi-square analysis was performed to determine any correlations between respondents' sociodemographic information and their health-seeking behavior. Additionally, logistic regression was used to forecast the elements that significantly influenced how people sought medical care. A 95% confidence interval and a P value of 0.05 were considered significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eDuring the study period, 494 participants were recruited. They were predominantly males (86.6%), with a mean age of 36.5 years (+/- 9.25 years). Most of them worked in the private sector (71.7%) and had an average monthly income of 4467 SRs (+/- 4097 SRs). Half of the respondents had no insurance or had informal insurance (44.1%). Only 20.3% reported having a chronic disease, with hypertension (10.5%) or diabetes mellitus (7.9%) being the most common. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of the studied population\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivisions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30-50-year-old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;50-year-old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorces, separated or widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHighest educational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary or secondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma or Bachelor's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e328\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher studies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment sector employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate sector employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNonskilled worker or crafts maker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed or retired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMonthly Income in SR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0-2000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2000\u0026ndash;5000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5000-10,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10,000\u0026ndash;30,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eDuration of residency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChronic diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eHealth insurance status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInformal insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSilver insurance (30K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGold insurance (50K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePlatinum insurance (100K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiamond insurance (250K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC insurance (500K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the first action taken by the respondents when they were faced with health issues. The majority of respondents claimed that they would go directly to primary health care (PHC), while only 3.4% reported that they would take a drug without a prescription. A total of 11.3% said they would self-diagnose themselves using the internet, 10.7% claimed they would consult an acquainted doctor, and only 7.9% said they would consult a pharmacist.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFirst action taken after encountering a health issue\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFirst Action\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGo to a hospital or PHC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsult a doctor from my acquaintances\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGo to the pharmacy and consult the pharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTry to diagnose and treat myself using the internet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGo and buy drugs directly without consultation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eApproximately half of the respondents denied taking any drugs without a doctor's prescription in the last 3 months (54.3%). Of the other half, 21.5% took it only once, 10.1% took it twice, 5.5% took it three times and 8.7% reported taking drugs without a prescription more than 3 times in the last three months. Moreover, 63.8% of the participants claimed they took drugs based on a doctor\u0026rsquo;s order, in addition to previous experience (45.5%), advice from friends or relatives (16.2%), and information found on the internet (21.2%), as shown in Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNumber of times drugs were taken without a doctor\u0026rsquo;s prescription in the last three months\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003efrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003epercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnce\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTwice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThree times\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than three times\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBasis for taking drugs in the last three months\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDoctor\u0026rsquo;s orders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e315\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFriend or relative advice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInformation on the internet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe variables that were significantly associated with health-seeking behaviors according to the chi-square test of independence included age (χ2 (4, n\u0026thinsp;=\u0026thinsp;494)\u0026thinsp;=\u0026thinsp;16.148, p\u0026thinsp;=\u0026thinsp;.003), marital status [χ2 (1, n\u0026thinsp;=\u0026thinsp;494)\u0026thinsp;=\u0026thinsp;11.657, p\u0026thinsp;=\u0026thinsp;.001], duration of residency in Saudi Arabia [χ2 (3, n\u0026thinsp;=\u0026thinsp;494)\u0026thinsp;=\u0026thinsp;18.956, p\u0026thinsp;\u0026lt;\u0026thinsp;.001] and health insurance status [χ2 (6, n\u0026thinsp;=\u0026thinsp;488)\u0026thinsp;=\u0026thinsp;23.382, p\u0026thinsp;=\u0026thinsp;.001]. However, we found no significant associations between health-seeking behavior and sex, occupation, monthly income, level of education, or the presence of a chronic disease, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between sociodemographic factors and positive health-seeking behavior\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003ePositive health-seeking behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eX2 value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e16.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u0026ndash;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003egender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e1.286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.257\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e232\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e12.351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary or secondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.787\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma or bachelor degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher studies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eoccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProfessional worker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNonskilled worker or crafts maker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed, Housewife, Student, or Retired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eIncome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e2.423\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eDuration of residency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e18.956\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChronic diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eHealth insurance status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e23.382\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInformal insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSilver insurance (30K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGold insurance (50K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePlatinum insurance (100K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiamond insurance (250K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC insurance (500K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA logistic regression model was used to further understand the effect of these factors on health-seeking behavior. The model was statistically significant, χ2 (1 1, n\u0026thinsp;=\u0026thinsp;494)\u0026thinsp;=\u0026thinsp;42.820, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. It explained 12.1% (Nagelkerke R2) of the variance in health-seeking behavior, and it correctly classified 69.4% of the cases. The Hosmer and Lameshow goodness of fit test showed a P value of 0.366. Out of the 4 variables we entered into the model, only age (OR [95% CI]: 1.032 [1.000-1.066]) and having no health insurance were found to be significant according to the model, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. The duration of residency and marital status were not significant.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic regression model\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u0026ndash;1.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.830\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.498\u0026ndash;1.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.476\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eHealth insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo health insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInformal insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.643\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.335\u0026ndash;1.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.184\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSilver insurance (30K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.877\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.446\u0026ndash;1.723\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.703\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGold insurance (50K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.527\u0026ndash;2.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.906\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePlatinum insurance (100K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.994\u0026ndash;6.553\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiamond insurance (250K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.909\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.708\u0026ndash;5.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC insurance (500K SR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.634\u0026ndash;9.747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.192\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eDuration of residency in KSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.390\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwo to five years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.326\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.715\u0026ndash;2.458\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.370\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFive to ten years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.913\u0026ndash;3.587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.640\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.802\u0026ndash;3.354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo the best of our knowledge, this is the first study assessing the health-seeking behavior of Sudanese expats in Saudi Arabia. We define a positive HSB as going to a primary health-care institution when faced with a medical issue. We found a 66.6% rate of positive HSB. These results align with those of other studies performed in Malaysia (66.7%), Nigeria (63%) and India (74.6%). (\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). We also aimed to analyze the associations between HSB and sociodemographic factors. Overall, we found that only insurance and age are significant factors.\u003c/p\u003e \u003cp\u003e \u003cb\u003eINSURANCE\u003c/b\u003e \u003c/p\u003e \u003cp\u003ePrior research indicates that health insurance lowers the cost of hospital stays and medication, allowing people to receive better medical care while treating a variety of illnesses. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)However, other research has demonstrated that insurance does not significantly increase the use of health services, particularly in situations where individuals still receive high-quality care even if they do not have insurance. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) Nonetheless, the positive effect of insurance is more significant in marginalized populations. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eThis study revealed that there is a strong association between health insurance status and positive or negative health-seeking behavior. In this study, almost half of the participants (43.7%) had no or informal insurance. This percentage is higher than that demonstrated in a wider-scale study conducted on Saudi expats, which found that only 30% of expats were uninsured. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) However, the latter study had very different demographics, with participants all being male and the majority being non-Arab workers, and with no mention of the number or the mere existence of Sudanese participants.\u003c/p\u003e \u003cp\u003eInformal insurance is publicly considered a way for companies and employers to evade authorities without providing workers with actual health insurance coverage. According to Saudi Labor Law, employers must bear the responsibility for paying all necessary medical expenses for their expatriate employees (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), yet many expatriate workers and their families remain uninsured.\u003c/p\u003e \u003cp\u003eThe link between health insurance coverage and HSB was also demonstrated in a similar study conducted on Saudi and non-Saudi nationals in KSA. It was found that \u003cem\u003ereceiving health insurance increases the chances of attending a medical check-up by approximately 13% among Saudis, while it has a 20% increase in non-Saudis\u003c/em\u003e. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) These results were also aligned with a qualitative study on low-income Bangladeshi migrant workers from the United Arab Emirates, in which the participants described insurance structures as barriers to achieving good health. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cb\u003eAGE\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe results of this study revealed a strong association between HSB and age, indicating that older participants were more likely to seek appropriate healthcare. This could be partially due to a greater sense of responsibility in elderly individuals and/or a greater incidence of chronic illness. A valid theory would also be that older Sudanese expats are most likely experts in their professions and have better access to higher categories of health insurance. This positive association was similarly described in a study in Senegal that found an increase in the odds of seeking healthcare among people older than 40 years, (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) contradicting the findings of another study conducted in Iran that revealed an inverse relationship between age and appropriate HSB, where older people were less likely to seek healthcare. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cb\u003eMonthly Income\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAlthough the association with insurance was significant, monthly income was not. This is contrary to the belief that better income will instantly mean better access to healthcare and affordability of health services. However, this finding aligns with that of another study that was conducted on both Saudi and non-Saudi people in Al-Ahsa, in which monthly income itself was not significant but rather how people perceived their economic status was. (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). We believe that the immigration status of our participants might have influenced these results; non-Saudis do not have access to free medical care in governmental facilities that Saudis receive. Therefore, expatriates treat their curative health problems either by insurance or, in the worst-case scenario, by out-of-pocket payments. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)Nonetheless, the average monthly income for Saudis is approximately 10,000 SR, and 94.5% of our participants had a monthly income below this average. In general, the average monthly income for non-Saudi workers is less than half that of Saudi people (4500 SR); this finding shows that the increase in monthly income for expats is too minimal to influence their healthcare decisions compared to insurance that grants them significantly cheaper healthcare services even in its lowest categories.\u003c/p\u003e \u003cp\u003e \u003cb\u003eNegative HSB\u003c/b\u003e \u003c/p\u003e \u003cp\u003eDespite a relatively high percentage of positive HSB in our sample, 45.7% of the participants practiced self-medication without a doctor's prescription. This is a high percentage compared to that in other countries such as Malaysia (11.8%)(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) but an extremely low percentage compared to that in Sudan. The percentage of self-medication in Sudan according to a recent study was 100%. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) Another study that assessed self-medication with antibiotics reported 87% of the participants. (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e) This highlights the importance of healthcare system affordability and health insurance in promoting positive HSB, in addition to strict regulations that prevent pharmacists from giving drugs without prescriptions.\u003c/p\u003e \u003cp\u003eUnexpectedly, very few of our participants reported using the Internet as a source of health and treatment information. This finding does not align with the findings of other studies in KSA, which showed that 92.6% of their sample used social media as a source of medical information. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) Despite the lack of significant research discussing the online HSB of the Sudanese population, we cannot disregard such a low rate. Although it protects against misinformation and self-medication, it cuts those Sudanese people off online health awareness campaigns and health education in general.\u003c/p\u003e"},{"header":"Strength and limitations","content":"\u003cp\u003eAs the first paper to be written on the health-seeking behavior of Sudanese expats, our study provides a foundation for future research and programs aimed at improving the health status and healthcare access of Sudanese immigrants and refugees worldwide. With the ongoing war in Sudan leading to a surge in refugees, our findings are particularly relevant and timely.\u003c/p\u003e \u003cp\u003eWhile our study sheds light on the health-seeking behavior of Sudanese expats, it is limited by its convenient sampling method, which may not accurately represent the larger population. Additionally, the low percentage of females in our sample calls for further research to explore the impact of gender on health-seeking behavior. Furthermore, our study focused on health-seeking behavior toward any illness or medical issue, which may not reflect the behavior toward specific illnesses that could be influenced by factors such as severity and duration.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eUnderstanding the determinants of health-seeking behavior (HSB) among immigrant groups is crucial for improving healthcare access and resource allocation for this population. As inappropriate HSB has been linked to poorer health outcomes, identifying the factors that influence HSB can provide valuable insights into designing tailored health interventions to support the Sudanese expatriate community in Saudi Arabia.\u003c/p\u003e \u003cp\u003eThis study highlights the significance of insurance as a determinant of HSB, emphasizing the need for reforming current insurance policies that prioritize private companies over the health of expatriates. Further research is needed to explore the healthcare preferences and behaviors of Sudanese people and other expats, particularly women and young people, to develop targeted policies aimed at reducing socioeconomic disparities in accessing healthcare services. By promoting universal health coverage, these policies can contribute to achieving sustainable development goals and improving the overall health and well-being of immigrant populations.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.555555555555557%\" valign=\"top\"\u003e\n \u003cp\u003eHSB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"76.44444444444444%\" valign=\"top\"\u003e\n \u003cp\u003eHealth-seeking behavior\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.555555555555557%\" valign=\"top\"\u003e\n \u003cp\u003eKSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"76.44444444444444%\" valign=\"top\"\u003e\n \u003cp\u003eKingdom Saudi Arabia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.555555555555557%\" valign=\"top\"\u003e\n \u003cp\u003ePHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"76.44444444444444%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary health care\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by two experts from the community medicine department at the University of Khartoum. The participants consented to\u0026nbsp;participate\u0026nbsp;in the study by signing an electronic consent form. The significance of the study and its goals were\u0026nbsp;also conveyed. Individuals were made aware that participation in the study was optional and that they had the right to revoke consent at any time. Additionally,\u0026nbsp;the confidentiality of the information gathered was emphasized.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The authors received no funding for the conceptualization, design, data collection, analysis, decision to publish, or preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN.E. conceptualized the research idea and collected the data.\u003c/p\u003e\n\u003cp\u003eH.A. reported the results and prepared the tables.\u003c/p\u003e\n\u003cp\u003eH.A. and N.E. analyzed the data and wrote the main manuscript text.\u003c/p\u003e\n\u003cp\u003eBoth Authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our appreciation to our professors at the community medicine department, University of Khartoum, for their support. Many thanks go to all the respondents for their participation in this survey, and we sent them our hopes for a better and peaceful Sudan.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLatunji OO, Akinyemi OO. FACTORS INFLUENCING HEALTH-SEEKING BEHAVIOUR AMONG CIVIL SERVANTS IN IBADAN, NIGERIA. \u003c/li\u003e\n\u003cli\u003eKenya. Do you need up-to-date peer reviewed medical literature? KMA/GSK RESOURCE CENTRE. Vol. 28. 2002. \u003c/li\u003e\n\u003cli\u003eCronin T, Sheppard J, de Wildt G. Health-seeking behaviour for schistosomiasis: A systematic review of qualitative and quantitative literature. Vol. 16, Pan African Medical Journal. 2013. \u003c/li\u003e\n\u003cli\u003eWebair HH, Bin-Gouth AS. Factors affecting health seeking behavior for common childhood illnesses in Yemen. Patient Prefer Adherence. 2013 Jan;7:1129\u0026ndash;38. \u003c/li\u003e\n\u003cli\u003eAnsong E. 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Impact of community-based health insurance on access and financial protection: Evidence from three randomized control trials in rural India. Health Economics (United Kingdom). 2016 Jun 1;25(6):675\u0026ndash;87. \u003c/li\u003e\n\u003cli\u003eAl-Hanawi MK, Mwale ML, Kamninga TM. The effects of health insurance on health-seeking behaviour: Evidence from the Kingdom of Saudi Arabia. Risk Manag Healthc Policy. 2020;13:595\u0026ndash;607. \u003c/li\u003e\n\u003cli\u003eMinistry of Labour Riyadh. Ministry of Labour, Labour Law. Riyadh; 2006. 120\u0026ndash;120 p. \u003c/li\u003e\n\u003cli\u003eL\u0026eacute;pine A, Le Nestour A. The determinants of health care utilisation in rural Senegal. J Afr Econ. 2013 Jan;22(1):163\u0026ndash;86. \u003c/li\u003e\n\u003cli\u003eAlmaqhawi A, Alsayil S, Al Qadhib M, Alkhoufi A, Alkhalaf A, Al Khowildi Z. Patient\u0026rsquo;s Perspective on Factors Affecting Health-Seeking Behavior in Al-Ahsa, Saudi Arabia. Cureus. 2022 Oct 8; \u003c/li\u003e\n\u003cli\u003eIsameldin E, Saeed AA, Mousnad MA. Self-medication Practice among patients living in Soba-. 2020;4:1\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eHussain MA, Mohamed AO, Abdelkarim OA, Yousef BA, Babikir AA, Mirghani MM, et al. Prevalence and Predictors of Antibiotic Self-Medication in Sudan : A Descriptive Cross-Sectional Study. 2023;1\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eAlmuammar SA, Noorsaeed AS, Alafif RA, Kamal YF, Daghistani GM. The Use of Internet and Social Media for Health Information and Its Consequences Among the Population in Saudi Arabia. 2021;13(9). \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Health-seeking behavior, Healthcare-seeking behavior, Factors influencing health-seeking behavior, Sudanese expatriates, Saudi Arabia, Health insurance","lastPublishedDoi":"10.21203/rs.3.rs-3848931/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3848931/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eImmigrant groups face prejudice and have limited access to healthcare. In Saudi Arabia, expatriates are particularly socially disadvantaged. Saudi Arabia has taken the lead in drawing enormous numbers of Sudanese professionals and technical labor throughout the years and is becoming an increasingly preferred destination after the Sudanese War of April 15, 2023. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia, as understanding these factors is important for improving healthcare access and health outcomes.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted targeting Sudanese residents of KSA via convenient sampling. A self-administered questionnaire was distributed electronically and 494 participants were recruited for the study.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThis study showed that the majority of the participants (66.6%) visited a primary healthcare center when faced with a medical problem. However, the prevalence of self-medication in the past three months was 45.7%. Only age (OR [95% CI]: 1.032 [1.000-1.066]) and not having health insurance were found to significantly influence health-seeking behavior.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study emphasizes the importance of understanding healthcare-seeking behavior among immigrant groups, particularly Sudanese expats in Saudi Arabia. It highlights the significance of insurance as a determinant of healthcare-seeking behavior and calls for reforming current policies to reduce disparities in accessing healthcare services.\u003c/p\u003e","manuscriptTitle":"Factors Influencing Health-Seeking Behavior Among Sudanese Expatriates in Saudi Arabia, 2023. 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