Factors associated with health seeking behavior in a two way health delivery system (modern publicly sponsored health services and traditional African health services), among the Banyala of Kakamega district

Abstract

This study is about factors associated with health seeking behavior in a two way health delivery system (modern publicly sponsored health services and traditional African medicine), among the Banyala of Kakamega district. It examines socio-economic factors, accessibility factors and beliefs and knowledge about the causes of illness as major determinants, in the choice and utilization of the available health services.

Modern publicly sponsored health services were introduced in Kenya by church missionary organizations and later by the British colonial government at the beginning of this century. However, the indigenous Kenyans had their own traditional ways of preventing, alleviating and treating different illnesses that confronted their daily lives, depending on their culture and understanding of the given illness.

With the introduction of a new medical care system, alien to them, it is of interest to examine how the two systems alternate in trying to alleviate the physical, mental and social maladjustments that confront our daily lives.

In this study, the penetration of modern health services and its distribution is examined. Cross-cultural studies that indicate the persistence of traditional health in spite of the advanced technological innovations in modern medicine are also examined.

Four major theories are used to explain health seeking behavior. Thus, the sick role theory; models of health seeking behavior; the theory of cognitive dissonance and the theory of central places.

In this study it was found out that 89.6% of the household heads have at least utilized modern health services in their lifetime. On the other hand 74% of the household heads had availed themselves of the use of traditional medicine in their lifetime. It was also found out that age and education among all the socio-economic factors had a more significant bearing in the utilization of the two health delivery systems.

The Banyala also identify infectious agents, deficient nutrition, sorcery, witchcraft and ancestral spirits as cause of illness and ultimately classify illness into those caused naturally and supernaturally. This also influenced their choice of a given therapeutic system.

Some scholars have isolated various socio-economic factors to influence the choice of private and public health services. In this study, where traditional African medicine and modern publicly sponsored health services are examined, socio-economic factors only accounted for 33.2% of the variance in health service utilization, with age and education playing a more significant role respectively. Accessibility factors explained 85.4% of the variance in health service utilization, with distance, mode of transport and time illness occurs, contributing higher coefficients than the rest of the accessibility factors. The classification of illness into natural and supernatural illness was also found to be statistically significant in the choice of a therapeutic system. Households where members were considered to be suffering from supernatural illness were taken for traditional medical care. However, traditional healers also treated naturally caused illness.

In conclusion, both health care systems are important in dealing with physical, mental and social maladjustments. The cultural traits of a community play a vital role in their response to health facilities. Efforts should be directed towards organizing health services in terms of the cultural and socio-economic characteristics of a given community.