Pigeon-Gagné Émilie, Yaogo Maurice, Saïas Thomas, Hassan Ghayda, Bambara Judicael
Sante Publique. 2022;34(2):299-307.
In Burkina Faso, there is a lack of studies on perceptions of existing mental healthcare systems. This limits understanding patients’ treatment pathways and barriers to care utilization. As in many countries in sub-Saharan Africa, this lack of information contributes to the difficulty of health systems to adapt the available care to patients’ realities and needs.
In this study, participant observations were made in different care settings in the city of Bobo-Dioulasso. Seven focus groups and 25 individual interviews were conducted to question knowledge, perception, and use of existing services. Different actors were interviewed: patients, caregivers, family members and key informants. The data were subjected to a descriptive thematic analysis.
Three systems of care were identified: 1) psychiatric care was associated with a diagnostic function and the management of serious pathologies, or ones triggered by “natural” causes, 2) traditional care was seen as having a healing function for “supernatural” pathologies, but was associated with a risk of fraud, and 3) informal care provided by the family was identified as the mainstay of the therapeutic pathways.
This study reveals that through the diversity of resources consulted, the family members represent the main provider of care. Also, financial constraints constitute the main obstacle to seeking care. These findings lead us to make recommendations regarding the development of public policies at the national level as well as regarding the organization of health services in the city of Bobo-Dioulasso.
在布基纳法索,缺乏对现有精神卫生保健系统认知的研究。这限制了对患者治疗途径以及护理利用障碍的理解。与撒哈拉以南非洲的许多国家一样,这种信息缺失导致卫生系统难以根据患者的实际情况和需求调整现有的护理服务。
在本研究中,对博博迪乌拉索市不同护理场所进行了参与观察。开展了7个焦点小组讨论和25次个人访谈,以询问对现有服务的了解、认知和使用情况。采访了不同的参与者:患者、护理人员、家庭成员和关键信息提供者。对数据进行了描述性主题分析。
确定了三种护理体系:1)精神科护理与诊断功能以及严重病症或由“自然”原因引发的病症的管理相关;2)传统护理被视为对“超自然”病症具有治愈功能,但与欺诈风险相关;3)家庭提供的非正式护理被确定为治疗途径的支柱。
本研究表明,通过咨询多种资源,家庭成员是主要的护理提供者。此外,经济限制是寻求护理的主要障碍。这些发现促使我们就国家层面公共政策的制定以及博博迪乌拉索市卫生服务的组织提出建议。