Abstract
BACKGROUND: Construction workers face high levels of occupational health risks and hazards, yet little is known about their health seeking behaviours. Understanding the patterns, barriers, and facilitators of health seeking among these workers is essential to improve access to care and prevent adverse health outcomes. This systematic review explores the patterns of health seeking behaviours, the factors influencing such behaviours, assess impacts of the health seeking behaviours and effective interventions to improve health seeking among construction workers. METHODS: We conducted a systematic review in accordance with the PRISMA 2020 guidelines. Eligible studies were identified through searches in PubMed, ScienceDirect, and Google Scholar from inception to January 14, 2025. Studies were selected via a PECOS framework, and the inclusion criteria comprised peer-reviewed quantitative and qualitative studies published in English. The risk of bias was assessed via appropriate JBI critical appraisal tools and the ROBINS-I tool. Data were extracted independently by two reviewers and synthesized thematically. RESULTS: Of 1669 records identified, 16 studies met the inclusion criteria after screening and quality appraisal. Most studies were conducted in low- and middle-income countries with varied methodologies. Health seeking behaviours were classified into five predefined domains: reactive/illness-related, proactive/preventive, avoidance/delayed, informal, and mental health seeking. The predominant pattern was reactive health seeking following illness or injury. Barriers included lack of awareness, financial constraints, personal beliefs, limited workplace support, and healthcare inaccessibility. Facilitators included health education, workplace regulations, accessible health services and support systems. The impact of the health seeking behaviours included financial burdens, loss of worker days and psychosocial stress. Effective interventions included health and safety training, outreach programs, digital mental health tools, and improved occupational health policies. CONCLUSIONS: Construction workers predominantly engage in reactive health seeking, with significant barriers impeding timely and effective healthcare utilization. These behaviours result in preventable health and economic consequences. Interventions that improve awareness, accessibility, workplace policies, and mental health support are urgently needed. Future research should explore longitudinal patterns and evaluate context-specific interventions to improve health outcomes among construction workers. TRIAL REGISTRATION: PROSPERO registration number CRD42025636549. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-26173-8.