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Sci Rep
Sci Rep
Scientific Reports
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Nature Publishing Group UK London

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69921
10.1038/s41598-024-69921-3
Article
Health checkup practice and its associated factors among adults in South Gondar zone Ethiopia
Yirga Gebrie Kassaw gebriekassaw27@gmail.com

1
Bantie Berihun 1
Hiruy Endalk Getasew 5
Baye Astewle Andargie 1
Kerebeh Gashaw 2
Shiferaw Kirubel 4
Wassie Fentahun Diress 3
1 https://ror.org/02bzfxf13 grid.510430.3 Department of Adult Health Nursing, College of Health Science Debre Tabor University, Debre Tabor, Ethiopia
2 https://ror.org/02bzfxf13 grid.510430.3 Department of Child Health, Nursing College of Health Science Debre Tabor University, Debre Tabor, Ethiopia
3 https://ror.org/02bzfxf13 grid.510430.3 Department of Surgery, College of Health Science Debre Tabor University, Debre Tabor, Ethiopia
4 https://ror.org/02bzfxf13 grid.510430.3 Department of Integrated Psychiatry, College of Health Science Debre Tabor University, Debre Tabor, Ethiopia
5 https://ror.org/04sbsx707 grid.449044.9 0000 0004 0480 6730 Department of Adult Health, Nursing College of Health Science Debre Markos University, Debre Tabor, Ethiopia
11 9 2024
11 9 2024
2024
14 2123722 1 2024
9 8 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Non-communicable diseases are the current global burden including in sub-Saharan Africa, which increasing the incidence of cardiovascular disorders and their complications due to a lack of health checks and delayed treatments. To assess health checkup practice among adults in the South Gondar zone of northeast Ethiopia in 2022. A community-based cross-sectional study design was employed from July 30, 2022, to August 30, 2022. Three woredas (Debre Tabor, Guna Beyemidir, and Andabet) were selected by using a simple random sampling method from the south Gondar zone, and three kebeles were selected randomly from each woreda. A complete of 422 samples were selected by random sampling technique. Data were collected in a face-to-face interview using structured questionnaires. The collected data were entered into Epi data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Binary logistic regression was done to identify the association between each variable with the outcome variable. A variable that had a p-value < 0.25 in binary logistic regression became a candidate for multivariate logistic regression then after factors p value < 0.05 was considered as predictors to the outcome variable. In this study, health checkup practice was 40.2%. Living with families (AOR 3.36; 95% CI 1.47–7.66), presence chronic disease (AOR 2.52; 95% CI 1.49–4.26), No self-medication practice (AOR 5.39; 95% CI 3.06–9.49) and having health insurance (AOR 3.02; 95% CI 1.68–5.430) were significantly associated with regular health checkup practice. Health checkup practice was low as compared to health policy recommendations and its health maintenance value. Creating awareness about health check-ups and prevention of disease complications will be taken by different stakeholders in the health care system

Keyword

Health Checkup Practice Ethiopia
Subject terms

Health care
Risk factors
issue-copyright-statement© Springer Nature Limited 2024
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pmcIntroduction

Medical check-up is the routine medical evaluation of healthy individuals to detect abnormalities. Regular checkups are necessary to detect problems like heart disease, cancer, diabetes, and others1. It is a means of disease prevention that helps to promote health in the community and plays an essential role in health care2,3. Chronic non-communicable diseases (NCD) accounted for almost 60% of global mortality, and 80% of deaths from NCD occurred in low- and middle-income countries4. Non-communicable diseases represent the current global burden including sub-Saharan Africa, which increasing the incidence of cardiovascular disorders5. Thus health checks showed any current disorder including risk factors for disease to early prevention of morbidity and mortality6,7.

WHO recommends each year, healthy women are invited for a comprehensive health check-up8. Routine health checkups became an annual medical care in the United States9. Medical checkups should be recommended to the elderly, taking into account not only their basic characteristics such as sex and occupation but also lifestyle, self-rated health status, and Activity of daily life, which are associated with medical checkup participation10. No communicable diseases contributed to 39.3% of the total deaths, 53% of the age-standardized death rate, and 34% of Disability-adjusted life years from all causes11. It is double the burden of infectious diseases which is predicted seven out of every 10 deaths in developing countries12.

In Japan, the country's health policy recommends and provides free annual health check-ups to detect and prevent complications. This may be one factor that they have the longest life span in the world13.

Findings at the workplace showed that the prevalence of undiagnosed hypertension was 50% in South Africa14. The national estimate of the prevalence of NCD risk factors showed high rates of raised blood pressure (16%), hyperglycemia (5.9%), hypercholesterolemia (5.6%), overweight (5.2%), and Obesity (1.2%)15. WHO revealed that 39% of the total deaths in Ethiopia were caused by NCD16. Routine physical checkups are essential for the whole population including childhood and adolescence16. Routine physical checkups are essential for the whole population including childhood and adolescence17. Even though Health professionals had enough awareness and a progressive approach toward routine health checkups practice was poor18.

A study conducted in Tikur Anbessa Specialized Referral Hospital, in Ethiopia showed that 80% of patients seen at the OPD with newly diagnosed diabetics presented with DKA, and most of them (56.4%) came late19. Additionally, the burden of undiagnosed hypertension was 21.2% in southwest Ethiopia among Adults in Urban Communities20. In a study conducted in Tikur Anbessa Specialized Referral Hospital, Adis Abeba in Ethiopia around 86.3% of the women had delayed diagnosis of cervical cancer21.

Screening and periodical medical examinations are two of the most important aspects of public health as they help to diagnose diseases at an early stage, even before showing any symptoms22. Routine medical check-up is essential to prevent disease and complication minimizes future hospitalization and related costs and improves health and quality of life23,24. Screening tests are important not only for early detection but also as a cost-effective measure from a public health perspective25.

Ethiopia has been reducing deaths related to communicable but minimal success with NCD which leading cause of premature mortality and morbidity26. Poor medical check-up practices may contribute to this premature mortality and morbidity in which diseases were diagnosed later after the advanced stage and complications even at the time of life ending. The current trend in patient disease management in Ethiopia is mainly focused on purely curative rather than integration with preventive medicine27. In Ethiopia, several studies were conducted on health-seeking behavior practice but studies were limited to health check-up practice. “Preventive is more than curative” So this study is intended to determine the practice and factors that affect health check-ups which is a disease preventive strategy.

Methods

Study design and period

A community-based cross-sectional study design was employed from July 30, 2022, to August 30, 2022.

Study area

The study was employed in the south Gondar zone which is found in the Amhara region Northwest, Ethiopia. South Gondar Zone is located in the Amhara region and its capital city Debre Tabor is 667 km Northwest of Addis Ababa, the capital city of Ethiopia, and 103 km to the southwest of Bahirdar. There are 21 Weredas and 401 kebeles with a total population.

Source population

The study includes all residents living in South Gondar, Northwest Ethiopia.

Study population

The study population comprises all adults aged 18 years and older residing in South Gondar, Northwest Ethiopia.

Study samples

The study includes all adults aged 18 years and older residing and directly involved in the study in South Gondar, Northwest Ethiopia.

Eligibility criteria

Inclusion criteria

The study includes all people above 18 years old who were living in south Gondar.

Exclusion criteria

People who were seriously ill and incapable of hearing and speaking at the time of data collection were excluded.

Dependent variable

Health check-up practice.

Operational definition

Health check-up

Medical checkup is defined as one or more visits with a healthcare provider for the primary purpose of assessing individuals’ overall health status and risk factors to detect any a disease abnormality or without developing any sign and symptoms28.

Sample size

The sample size was calculated by using the single population proportion formula (n = [(Zα/2)2 × P (1 − P)]/D2), by assuming, that a prevalence of periodic medical checkups was 50% and 95% CI 1.96, the margin of error 5% and by considering 10% non-response rate, the final sample size was 422.

Sampling procedure

Three woredas (Debretabor, Guna Beyemidir, and Andabet) were selected by using a simple random sampling method from the south Gondar zone, and three kebeles were selected randomly from each selected Woredas. A total of 422 households were proportionally allocated to each sampled kebeles depending on the number of residents of the Kebele. Systematic sampling was used to select the study household and the respondents were one member of the household selected randomly.

Data collection tools and procedures

A structured questionnaire was used for data collection which was adapted from different related literature3,23,26. Data were collected in a face-to-face interview using a structured questionnaire. A pretest was conducted to check the functionality of the tools other than the study area.

Data quality control and analysis

The questionnaire prepared in English was translated into the local language, Amharic, and then to ensure consistency, it was retranslated to English. A pre-test was conducted on 21 participants in non-selected Hospitals 2 weeks before the actual data collection. Training was given to data collectors on the content of data collection tools and ways of approaching the interviewee. Each participants were recruited and oriented about the study's immediate prior data collection.

Data processing and analysis procedure

After data collection, data were first checked and coded. Then collected data was entered into Epi data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Descriptive statistics were presented by using text, tables, and figures. Simple and multiple logistic regression analyses were performed to determine the association factors. The outcome variable (health check-up practice) was categorized as having regular health check-ups practice and not having regular medical check-ups. Binary logistic regression was done to identify the association between each variable with the outcome variable. Then after, the Variable that had a p-value < 0.25 in binary logistic regression became a candidate for multivariate logistic regression. Homer and Lemeshow's test was checked for model goodness of fit. During the analyses, 0.05 p-value, and 95% confidence interval (CI) were used. Factors p value < 0.05 were considered as predictors of the outcome variable.

Ethics approval and consent to participate

The study was carried out after a letter of approval was obtained from the ethical review committee of Debre Tabor University College of Medicine and Health Sciences accordingly declarations of Helsinki. A formal letter was provided to selected hospitals in south Gondar hospitals preceding data collection. Informed verbal consent was obtained from each participant’s anonymity.

Results

Socio-demographic characteristics of the participants

A total of 410 participants were involved with a response rate of 97.2%. Age ranged from 19 to 74 years with a median age of 40 years. Of the total of participants 206 (50.2) were female. Of the total participants, 48.7% were urban residents (Table 1). Table 1 Socio-demographic distribution of study participants living in south Gondar Ethiopia 2022 (N = 422).

Variables	Category	Frequency	Percentage	
Sex	Male	204	49.8	
Female	206	50.2	
Age	15–44	261	63.7	
45–64	120	29.3	
≥ 65	29	7.1	
Marital status	Single	101	24.6	
Married	250	61	
Divorced	16	3.9	
Widowed	43	10.5	
Residency	Rural	212	51.7	
Urban	198	48.7	
Living	with families	364	88.8	
Living alone	46	11.2	
Educational status	Unable to read/write	162	39.5	
Primary	84	20.5	
Secondary	77	18.8	
Diploma	41	10	
Degree and above	46	11.2	
Perceived distance from health facility	Near	105	25.6	
Far	305	74.4	
Transport access	Yes	208	50.7	
No	202	49.3	
The age category was taken29.

Health-related information

Medical checkup practice was 40.2% with 95% CI (35.4–44.6). Of the total study participants, 182 (44.4%) had chronic disease and 60% of the participants had community-based health insurance (Table 2). Table 2 Health-related information on study participants living in south Gondar Ethiopia 2022 (N = 422).

Variables	Category	Frequency	Percentage	
Having chronic disease	Yes	182	44.4	
No	228	55.6	
Having health insurance	Yes	246	60	
No	164	40	
Self-medication practice	Yes	165	40.2	
Having regular health check-up practice	No	245	59.8	
Yes	165	40.2	
No	245	59.8	

Factors associated with medical checkup practice

In this study, check-ups people who had health insurance were more likely to practice routine check-ups than those who were not members of health insurance. Similarly, People who had chronic disease more practiced periodic medical checkups than those who had no chronic disease (Table 3). Table 3 Bivariate and multivariable logistic regression of periodic medical checkups in south Gondar North West Ethiopia, 2022 (N = 422).

Variables	Category	Medical checkup practice	COR (95% CI)	AOR (95% CI)	
Yes	No	
Educational status	Unable to read and write	62	100	1	1	
Primary	36	48	0.83 (0.48–1.41)	1.58 (0.75–3.35)	
Secondary	45	32	0.44 (0.25–0.77)	0.65 (0.26–1.61)	
Diploma	12	29	1.5 (0.71–3.15)	1.44 (0.55–3.73)	
Degree	10	36	2.24 (1.04–4.82)	1.74 (0.65–4.64)	
Marital status	Single	65	34	1	1	
Married	78	172	1.81 (0.88–3.71)	0.77 (0.27–2,20)	
Divorced	2	7	12.1 (2.61–16.24)	4.23 (0.77–13.23)	
Widowed	20	25	3.81 (2.35–6.2)	1.94 (0.95–4.0)	
Residency	Urban	99	99	2.21 (1.48–3.30)	1.98 (0.91–4.27)	
Rural	66	146	1	1	
Living with	Families	151	213	1.62 (0.84–3.14)	3.36 (1.47–7.66)*	
Alone	14	32	1	1	
Having chronic disease	Yes	100	82	3.06 (2.03–4.60)	2.52 (1.49–4.26)*	
No	65	163	1	1	
Self-medication practice	No	134	111	5.22 (3.28–8.30)	5.39 (3.06–9.49)**	
Yes	31	134	1	1	
Perceived distance from health facility	Near	63	42	2.3 (1.90–4.71)	1.70 (0.95–3.07)	
Far	102	203	1	1	
Having health insurance	Yes	133	113	4.86 (3.06–7.70)	3.02 (1.68–5.430)**	
No	32	132	1	1	
Transport access	Yes	108	101	2.63 (1.75–3.95)	1.78 (0.85–3.78	
No	57	144	1		

Discussion

Periodic medical checkups are essential to increase life expectancy and quality of life30,31. The purpose of this study was to determine health checkup practices in south Gondar North West Ethiopia. In this study, health checkup practice was 40.2% (35.4–44.6) which was in line with a study conducted in Nigeria with 39.4%.30. Whereas it was higher than a study conducted on Saudi students which was (25.5%)32. This difference may be due to time, material; methodology used, and study population. However, it was much lower than the nationwide figure in the United States (70%)7. The discrepancy may be the health care system development, access to resources and health facilities, attitude, and awareness of the community, and being a member of health insurance can increase this community to taking part in periodic health checkups.

In this study, people living with their families had better periodic medical checkup practices than those who lived alone. Similarly, research showed Social support is factors that facilitate the use of regular healthcare services33. Another study also revealed that most of the elderly who live alone develop self-coping mechanisms to meet their healthcare needs rather than seek formal medical consultation34. This may be due to the absence of any responsible body to support, remind, encourage, and take them to health facilities.

People who had chronic disease more practiced periodic medical checkups than those who had no chronic disease. Similarly study in Saudi found that people with chronic conditions were more likely to use routine checkups compared to those without chronic conditions32. Another study also showed routine medical checkup practice is not common and only enhanced if there is a presence of comorbidity35. The possible justification maybe people with chronic conditions may have good awareness about routine medical checkups, they are suspicious of developing complications and they have regular follow-up appointments.

The study also showed people who didn’t practice self-medication were more likely to practice routine checkups than those who had self-medication practice. Similarly, studies revealed self-medication practice influences health care-seeking because of behavior and early diagnosis of problems and appropriate treatments36,37. This may be because individuals who practice self-medication focus on self-treatment rather than seeking standardized medical treatment. This study also revealed that people who had health insurance were more likely to practice routine checkups than those who were not and members of health insurance. Studies revealed that health insurance motivates check-ups and the chances of going for medical check-ups32,38. Similarly, studies revealed that individuals with higher levels of health insurance were more likely to receive medical check-ups39. This may be because health insurance reduces health expenditures and increases access to healthcare services.

Limitations of the study

There is a potential limitation of on sampling technique in which a simple random sampling technique was employed instead of using multistage sampling without considering the variation of the study population due to funding constraints and financial scarcity. Also, there is the short duration of the study period due to the nature of the study design as a limitation.

Conclusion

Health checkup practice was low as compared to WHO and different countries' health sector health policy recommendations and its health maintenance value. Creating awareness about health check-ups, prevention of disease complications and the disadvantages of self-medication practice will be taken by different stakeholders in the healthcare system.

Abbreviations

ASDR Age-standard death rate

DALYs Disability-adjusted life years

NCD Non-communicable disease

OPD Out patient department

Acknowledgements

We would like to thank South Gondar zone and selected woreda’s officers for their valuable information.

Author contributions

G.K. and B.B. participated in the conception, design of the study, and analysis of E.G.H., A.A., and K.S. interpretation of the data and drafting of the manuscript G.K. and F.D. participated in the analysis and revising of the manuscript critically.

Data availability

The raw data generated in this study are not shared publicly due to confidentiality but will be available from the corresponding author upon reasonable request.

Competing interests

The authors declare no competing interests.

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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