Socio - cultural and situational determinants of modern health care utilisation in mbita division of suba district

Abstract

The utilization of modern health care services has attracted the attention of many researchers and scholars in various parts of the world. This reveals the perceived crucially significant role that is globally attached to modern medical paraphernalia in addressing issues that hitherto appear to be pragmatically ubiquitous health problems. As spelt out in the Kenyan health policy, the objective of the Department of Health in the district is to provide improved curative, preventive and promotive health services. However, in spite of all these blueprints the utilization of these services has not been impressive especially in the rural areas. In this regard, this study examines the utilization pattern of modern health care services in a rural area in Kenya using household sample survey on socio-cultural and severity data in conjunction with community level data on availability of services. The study is a survey consisting of male and female household heads in Mbita Division of Suba District. The sample drawn' by cluster sampling consisted of interview administered questionnaires of open and close-ended questions. In addition, qualitative techniques (Key informant interviews, observations and focus group discussions) were used to collect in-depth information. The data was analysed both qualitatively and quantitatively and the Health Belief Model (HBM) used in the conceptual framework to aid in the interpretation of the research findings.

The study established that the existing health institutions are inequitably distributed apart from being few and devoid of the basic requisite facilities like laboratories and adequate staff besides inaccessibility. The results further strongly suggest that the low household income is a barrier to the utilization of modem health services even where they are cheaply and publicly provided. The study also established that the cultural attitudes and beliefs still influence people's choice of therapy especially those who believe that non-adherence to traditions (taboos) has a disease causal mechanism or influence. These people predominantly seek folk intervention to arrest such illnesses. In all the severe cases and epidemic diseases reported during the study, the respondents were unanimous that modem medical practices are sought even if it means organising a funds drive to achieve the desired goal. On the basis of the implications of the findings, the study recommends that public health education be aggressively employed to counteract some medically adverse social or cultural factors. This is in recognition of the fact that the success in this field requires awareness, public education, understanding, political goodwill and collaboration of Governmental and Non-Governmental agencies. Similarly, the provision of public facilities should not only be treated as being of necessity peripheral but should be emphasized since they are more important to both the rural and urban poor who, paradoxically, form the vast majority of the Kenyan population