Choosing among Parallel Health Care Systems in a Bariba Community

Abstract

It is increasingly common in developing countries to find the proliferation of parallel health care systems in which cosmopolitan and indigenous health services co-exist. The basis of people's decisions to select from among these health care options is not, however, thoroughly understood. In this paper, based on research conducted in the People's Republic of Benin in 1976-77, I intend to consider one dimension of health service utilization - namely, alternatives for obstetrical assistance utilized by women in a Bariba region of Benin. In subsequent sections, I will attempt to delineate a set of factors influencing women's choices of obstetrical care in this rural African setting and draw conclusions regarding the decision-making process among pregnant Bariba women. This research was conducted in northwestern Benin, particularly in the District of Kouande. The primary research site was the village of Pehunko, which has a population of about 2000 and is primarily Bariba. The Bariba are one of the three most populous ethnic groups in Benin, numbering perhaps 300,000 and extending into western Nigeria. Pehunko was chosen as the focus of this research because of its location as a crossroads market center, through which communications from surrounding settlements flow regularly. Pehunko is located at the intersection of several settlements with maternity care services and is the center of an agglomeration of villages. Pehunko, then, seemed to serve as an illustrative site to