Traditional and modern medicine in primary care - prevalence, patterns and predictive factors of utilisation in Makwarela township, Vhembe district, Limpopo
Thesis (MFamMed)-- Stellenbosch University, 2009.
Introduction: Medical pluralism is a worldwide phenomenon. The reality in South Africa is that healthcare is provided by both orthodox and traditional healthcare providers. There is a great reliance on traditional medicine (TM) especially in rural communities. The complex interplay between patient centeredness and empowerment, health economics, failure of the biomedical approach and many other factors has resulted in an increasing prevalence of medical pluralism. Aim: The aim of the study was to explore the existence and extent of medical pluralism in my practice population, to quantify the prevalence of use and to qualify the determinants of choice. Methods: A cross sectional community household survey was conducted in the Makwarela Township of the Thulamela municipality (which forms part of the Vhembe district in the Limpopo Province in South Africa) using systematic sampling based on interval numbers. Interviewer administered questionnaires were used to obtain information from 65 households. Information was collected regarding the dependent variables (illness episodes, consultation behaviour, choice of primary health care provider) and the independent variables (socio-demographics, characteristics of illness, characteristics of health services). These were then analysed to assess prevalence of use and to elucidate significant associations. Results: Only 48 households representing 73,8% of the sample agreed to be interviewed. The total household members numbered 242. There were 364 illness episodes experienced by the household members in the 6 months prior to the survey. The ever use of TM in the sample was 70,8% (57,9% - 83,7%, 95% CI), whereas the ever use of orthodox medicine was 100%. The percentage of respondents who feel that they would probably use TM in future was 50%. The only significant correlates of TM use were highest education, household size, health belief model, waiting times at OM practitioner and past utilisation of TM. Conclusion: The study confirms the hypothesis of the existence of a pluralistic primary healthcare system and high prevalence of use of TM in the sample. The pattern of use of TM is that of an adjunct rather than as exclusive therapy. The study also confirms the complex interplay of a myriad of factors in healthcare choice. Despite the limitations of the study it can serve as a preliminary investigation prompting further studies to elucidate healthcare utilisation in the province and nationally. There are many ensuing implications for healthcare providers, funders and health system planners.
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