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赞比亚卡莱博地区的就医行为及传统治疗师的利用情况

Health care seeking behaviour and utilisation of traditional healers in Kalabo, Zambia.

作者信息

Stekelenburg Jelle, Jager Bastiaan E, Kolk Pascal R, Westen Esther H M N, van der Kwaak Anke, Wolffers Ivan N

机构信息

Department of Obstetrics and Gynaecology, University Hospital Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.

出版信息

Health Policy. 2005 Jan;71(1):67-81. doi: 10.1016/j.healthpol.2004.05.008.

Abstract

OBJECTIVE

To identify traditional healers in the catchment area of Kalabo District Hospital and to investigate determinants which play a role in the choice between different health care options, and to explore possibilities for increasing co-operation between the District Hospital and traditional healers.

METHODS

In a cross-sectional comparative and descriptive study, a combination of both quantitative and qualitative methods was used. A total of 12 health workers, 13 traditional healers and 100 community representatives were interviewed, using (semi)-structured questionnaires. A focus group discussion was held with 12 traditional healers.

RESULTS

This study shows that all respondents are willing to visit the hospital if they fall ill in future, and 88% of the respondents will visit a traditional healer. More women than men visit traditional healers, but the men who do visit them, do so more frequently. Level of education is not an important determinant. Increasing age leads to more frequent visits to both the hospital and traditional healers. Almost half of the respondents (49%) only have to walk less than 30 min to a traditional healer, but the hospital is the same distance for only 34% of the respondents. Waiting time turned out to be an important factor: in the hospital, 48% of the respondents are not helped within time, and only 28% are not helped in time by the traditional healer. Demon possession, mbaci, kanono and infertility are typical health problems for which people visit a traditional healer. The cost of treatment from a traditional healer is usually one cow, but only if the patient is cured. Satisfaction was measured at 89% after hospital treatment, and 74% after treatment from a traditional healer. If dissatisfied with the traditional healer, 86% would consider attending the hospital.

摘要

目的

确定卡拉博区医院服务范围内的传统治疗师,调查在不同医疗保健选择之间做出抉择时起作用的决定因素,并探索加强区医院与传统治疗师合作的可能性。

方法

在一项横断面比较描述性研究中,采用了定量和定性方法相结合的方式。使用(半)结构化问卷对12名卫生工作者、13名传统治疗师和100名社区代表进行了访谈。与12名传统治疗师进行了焦点小组讨论。

结果

本研究表明,所有受访者表示如果未来生病愿意去医院就诊,88%的受访者会去看传统治疗师。看传统治疗师的女性比男性多,但看传统治疗师的男性就诊频率更高。教育程度不是一个重要的决定因素。年龄增长导致去医院和看传统治疗师的频率都更高。近一半的受访者(49%)到传统治疗师处只需步行不到30分钟,但只有34%的受访者到医院的距离相同。等待时间是一个重要因素:在医院,48%的受访者未能及时得到诊治,而传统治疗师处只有28%的受访者未得到及时诊治。被恶魔附身、mbaci、kanono和不孕是人们看传统治疗师的典型健康问题。传统治疗师的治疗费用通常是一头牛,但前提是患者被治愈。医院治疗后的满意度为89%,传统治疗师治疗后的满意度为74%。如果对传统治疗师不满意,86%的人会考虑去医院就诊。

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