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MATERIALS AND METHODS
Aging is a natural process of life span but in developing countries, aged person especially women lead a vulnerable life due to many socio-economic factors. This study was explanatory in nature and conducted using quantitative research design and numeric data. The survey method schedule was conducted collect data from the respondents. The total number of aged women was 307, considering the attributes of the unit of analysis from the three mentioned villages of Narail Upazila. The sample size of the study was 171, using simple random sampling. Fieldwork was conducted in two months of 2022, September and October, respectively, using an interview schedule. The data processed were analyzed and interpreted by using appropriate statistical techniques, both descriptive and inferential statistical techniques (Table 1).

Variables of the Study
The study was conducted with both independent and dependent variables. The independent variables are age, religion, marital status, education, living arrangement, size of the family, types of Houses, head of the household, total household income, total household expenditure, types of health problems, and duration of illness. The dependent variables are a response to seeking healthcare, nature of treatment, place of treatment, etc.
Ethical consideration
To conduct the study, permission was obtained from the authority of the respective Upazila. With their consent, data were collected from the study area. During the fieldwork, the researcher introduced themselves, disclosed the nature and purpose of the study, and obtained verbal consent from the respondents. Moreover, to keep the participants' anonymity, their names were not included in the interview schedule, and they were also assured that the information was only used for study purposes.
RESULTS
Most of the respondents had moderate health problems. All the respondents were suffering many health problems within the last year. The result reveals that the majority of the respondents (24.6%) suffered from diabetics, fever (23.4%), Gastrointestinal illness (11.1%), Aches and pain (15.2%), and other like blood pressure, kidney disease, skin disease, eye related problems, and waterborne illness respectively among the most common diseases suffered by respondents such as fever (17.0%), Gastrointestinal Diseases (13.5%), blood pressure (21.6%), eye diseases (15.2%), diabetics (12.3%), and Aches and Pain (20.0%) respectively. Most women suffered from these diseases in a short period (Table 2).

The above table explored the determining factors of health problems and healthcare-seeking behavior of aged women. In this table, it was found that the medical facility (49.1%) was in such a low condition that it greatly affected the respondents' health problems and healthcare-seeking behavior. The economic conditions of respondents (45.5%) had a highly adverse impact on their health problems and healthcare seeking behavior, 43.3% had medium effects, and 11.7% had low influences (Tables 3 & 4).


This result presents the association between the response in seeking healthcare behavior and its covariates. It was noted from the relation that respondents’ age had highly statistically significant effects on response in seeking healthcare by 11.413 and P 0.003. The table also reveals that marital status had a statistically significant effects on seeking healthcare behavior by 6.469 and P 0.039. Similarly, with the respondents' education, living arrangements were also highly statistically significant, with the respondent’s seeking healthcare by (x2= 9.835 and p <0.007) and (x2= 20.886 and P<0.000), respectively, in this table. The receiving assistance by x2= 1.344 and P Table 5).
This table reveals the association between health conditions and their covariates. These results showed that the respondent's age statistically affected the health condition by x2= 53.511 and P
DISCUSSION
This study aimed to explore the healthcare-seeking behavior of aged women under three factors: 1. Predisposing factors, 2. Enabling factors, and 3. Need factors as outlined in Andersen’s Behavioral Model of Health Services Use [13,14]. The healthcare-seeking behavior of aged women is highly associated with their personal, living, social-economic, and surrounding conditions. In developing countries like Bangladesh, many impediments affect the healthcare-seeking behavior of aged women. The current study found that most respondents were between 60 and 69 years old, followed by 70 to 79 and above 80 years old, respectively. A significant portion of the respondents were illiterate, and the rest had primary and secondary levels of education, respectively; according to the current study findings, the predisposing factors of respondent age were highly statistically significant with seeking healthcare and place of treatment. It was identified that most of the respondents above 70 needed to seek healthcare properly and promptly and faced more significant health problems. A different study found that younger people were more likely to seek healthcare earlier than older people [15]. The study's findings show that almost two-thirds of the respondents delayed seeking healthcare during illness. They generally seek healthcare delayed because most of the respondent live under the poverty line, their vulnerable socioeconomic conditions and the unavailability of healthcare centers nearby are highly influenced to seek healthcare later. Almost similar study found that most aged women seeking healthcare are delayed due to an individual's socioeconomic status, which is thus an essential factor [16]. The bivariate analysis (chi-square test) result also reveals a statistically significant relationship between marital status, living arrangements and their preference for healthcare. Most of the respondents who were divorced, widows and or children with families seeking healthcare were delayed. Similarly, the study in Bangladesh reported that seeking healthcare had a significant relation with their living arrangements and marital status [1]. A study also found a similarity between the respondents living arrangements and seeking healthcare; the majority who lived alone and in children's houses faced frequent health problems but delayed in seeking healthcare [17]. It was examined that most respondents have completed primary education, and the rest are illiterate. Result founded that the level of education had a highly significant relationship with seeking healthcare. A study in Nigeria shows that the high quality of education had a significant relationship with seeking healthcare promptly [18]. Some studies have found that older women with higher levels of education and those living in extended families are more likely to seek healthcare services.

For instance, a study on determinants of healthcare-seeking behavior among older women in rural Bangladesh revealed that the rates of seeking healthcare services were higher among older women with primary and secondary education, those living with spouses and children, and those residing in extended families with seven or more members [19]. This study shows that respondents who are working sought their healthcare promptly and decided to seek healthcare during illness compared to those who were not working [20]. They reported a more substantial relationship between respondents' working status and earning money when seeking healthcare. From the findings, it was also found that most of the respondents were suffering from fever, gastrointestinal illness, respiratory illness, aches and pain, diabetics, and skin or eye-related problems that were also found in this result of [21]. Near fifty percent of respondents faced discrimination for getting healthcare services due to lack of knowledge, poor economic conditions, or living in rural areas. Previous researchers also reported similar findings that rural women faced various forms of discrimination or harassment due to a lack of proper knowledge about proper healthcare facilities and also dominated by doctors, nurses as well as hospital staff [22]. The Pearson correlation result interprets a statistically positive and negative relation between respondents' age and monthly household income, cost of treatment, distance of health center from home, medical access, and response to seeking healthcare.
CONCLUSION
A pressing concern associated with aging in developing countries like Bangladesh is the health of the elderly population, particularly older women. These individuals face a multitude of health issues, including gastrointestinal problems, hypertension, diabetes, fever, eye-related conditions, asthma, and more. Most elderly women are economically dependent on others, lack primary education, savings, or access to allowances, and live with their children or within their household. Factors such as monthly family income and treatment costs were identified as significant impediments to seeking healthcare for aged women, leading to delays in seeking healthcare during illness. This finding could serve as an underpinning for developing an effective intervention that can promote health and well-being among aged women, ultimately leading to growing health outcomes for these rural vulnerable groups of people. It suggests that government and non-government organizations should collaborate to address poverty alleviation among the elderly, including initiatives like social safety net programs. There is a need to establish healthcare centers at the rural level in Bangladesh to improve healthcare access. It underscores the importance of addressing socioeconomic barriers and improving healthcare accessibility to enhance the quality of life for this vulnerable demographic.
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