Objective: The aim of this study was to explore possible differences in health care seeking behaviour among a
rural and urban African population.
Design: A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and
urban Setswana communities which represented different strata of urbanisation in the North West Province,
South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic
and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected.
Results: The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about
health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly
better than rural participants. Although most urban and rural participants consider their access to health care as
sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate
between urban and rural communities in this study indicated that participants of urban communities were more
likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly
budget, not only for health care itself, but also for transport to the health care facility. Urban participants were
more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988).
Conclusion: Recommendations are formulated for infrastructure investments in rural communities, quality of health
care and its perception, improvement of household socio-economical status and further research on the
consequences of delay in health care seeking behaviour