Perceived Changes in Health-Seeking Behaviour Following the COVID-19 Pandemic: A Qualitative Study of Urban and Rural Populations in Eastern Gujarat

Background and objectivesThe coronavirus disease 2019 (COVID-19) pandemic significantly disrupted healthcare systems and altered patterns of healthcare utilization worldwide.In India, where structural inequities in healthcare access persist, the pandemic may have influenced health-seeking behaviour differently across urban and rural populations.Understanding these behavioural shifts is critical for strengthening health system preparedness in future public health emergencies.This study aimed to explore, using a qualitative descriptive design, participants' perceived changes in health-seeking behaviour, healthcare preferences, and decision-making following the COVID-19 pandemic among adults aged 18-85 years living in urban and rural areas of eastern Gujarat, India. MethodsThis descriptive qualitative study was conducted as part of a larger mixed-methods investigation in eastern Gujarat between October 2023 and April 2025.Face-to-face, semi-structured, in-depth interviews were conducted with 20 purposively selected participants (10 from urban Vadodara and 10 from rural Sankheda taluka, Chhota Udaipur district).Interviews were conducted in Gujarati or Hindi, audio-recorded, and translated into English.The interview guide was pilot-tested and refined before data collection and was informed by the PASS model and relevant literature.Data were analysed using inductive thematic analysis, with codes organized into categories and themes through iterative review. ResultsFive major themes emerged.Participants described perceived changes in health-seeking behaviour following the COVID-19 pandemic.These included greater preference and trust in formal healthcare, alongside a continued preference for private facilities despite financial constraints.Healthcare decisions remained influenced by affordability, accessibility, perceived quality of care, symptom severity, and family considerations.Self-medication, home remedies, and other traditional systems of medicine continued to be used, particularly for minor illnesses.Telemedicine was viewed positively by some participants but had limited uptake.Participants also described greater attention to hygiene, diet, exercise, and other preventive practices. ConclusionsParticipants described perceived changes in health-seeking behaviour following the COVID-19 pandemic, including greater trust in formal healthcare and increased attention to preventive practices.However, financial constraints, accessibility barriers, perceived delays in public facilities, and continued selftreatment for mild symptoms remained important influences on healthcare decisions.These findings provide contextual insights into healthcare decision-making in the selected study settings.