The PASS-model: a model for guiding health-seeking behavior and access to care research

The mobilization of affordable measures and treatments has brought health services and health care tools closer to the poor. This is particularly the case in the context of malaria control and elimination efforts. Still, the other side of delivery is use: the targeted populations have to access and accept these resources. Although the need to better align the delivery and user sides is increasingly recognised, there still is a gap between this awareness and researchers’ response to adequately address the community side in a way that actionable results can be achieved. In order to avoid actions based on preconceptions, practical applications should draw from theoretical knowledge. Furthermore, in order to get a total view, such applications should consider the full array of potential factors relevant for access to care or health-seeking behavior (HSB). We believe that one of the reasons why theoretically-based, holistic approaches to HSB and access to care still are scarce is the lack of a hands-on and easy-to-use model that allows the researcher to ask the right questions and to interpret the results. In this article, we present such a model, the PASSmodel for HSB and access to care. Founded on theory, the model facilitates the formulation of questions to cover the broad array of elements that guide HSB and access to care. It is adaptable to different contexts and research questions. The goal is that any researcher interested in situating health behavior in a given social, political, and economic landscape can use this tool for any health condition, in low income as well as high income countries.