Abstract
Background: Access to healthcare may vary across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place. In the Indian scenario, most health-care expenses are paid out-of-pocket by patients and their families, rather than through insurance or social security schemes. Health-seeking behavior denotes visiting the health-care facility for need of care during diseases, injury and health related events which includes public hospitals, clinics or privately owned hospitals. There is a lack of inadequate information on health-care utilization and social security benefits availed by street vendors in India. Hence, the study was planned to look into issues of health-care utilization and related issues.

Aims and Objectives: To assess the utilization of health care and social security schemes among the street vendors of urban area of Bengaluru and to find the determinants of health-care utilization among them.

Materials and Methods: A community-based, cross-sectional, descriptive, and explorative study was undertaken for 2 months from May to June 2021 among 160 street vendors in urban area of Bengaluru. Data on socio-demographic factors, vending type and nature, social security benefits, health insurance, and health-care utilization were collected from each vendor. The prevalence of utilization of healthcare and social security schemes among street vendors were estimated.

Results: Majority of the vendors (77% males and 82.4% females) visit health-care center only when the illness was severe and only 18.8% of the vendors seek healthcare for all types of illnesses. Over-the-counter medicines were preferred than visiting a health-care facilities by 71.3% of the street vendors and majority of them were males (76.3%). The part time vendors (38.5%) used more than one health facility, i.e., government, polyclinic, and medical college facilities, whereas (27.2%) of full time vendors were dependent on government health-care facilities. The fixed place vendors (23.8%) and mobile cart vendors (32.7%) used government health-care facilities. Majority of the fruit vendors used government facilities. There were 20% of the street vendors who were aware of only Indira Gandhi National Old Age Pension Scheme (IGNOAPS), 18.8% aware of only Janani Suraksha Yojana (JSY) Scheme, 28% aware of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), 8% were aware of Pradhan Mantra Shram Yogi Maandhan Yojana (PM-SYM), and 9.4% aware of all the above schemes as applicable. Almost two third of the study population (69% of males and 61.8% of females) were not availing any of the social security schemes. 71.4% of males above 60 years of age were availing IGNOAPS, 31% of females in the reproductive age group availed JSY as applicable, 12% availed AB-PMJAY, 67.6% of the fixed place vendors, and 67.3% of the mobile cart vendors did not avail any social security scheme. None of the vendors had any type of medical health insurance and only 59.4% of the vendors were below poverty line card holders.

Conclusion: Most of the vendors and their family members used government facilities (26.9%) and only 44.4% were availing the social security schemes. Timing of vending (part/full time), time of visit of different health-care facilities, and financial status were the important determinants of utilizing healthcare. Therefore, government run health-care centers should be made more accessible and available to the unorganized working class.

Key words: Street Vendors; Healthcare Utilization; Social Security; Urban