Abstract
In African rural area, studies have shown under-utilization of rural health services. This situation occurs in a context of therapeutic pluralism that competes with access to the health service. The aim of this study is to analyze the place of the modern health care system at the heart of the search for childcare in a rural environment in Ferlo, Senegal. Methods: A cross-sectional study was carried out to examine the place modern health care in the stages of the therapeutic itinerary among children living in Senegal rural area in March 2017. Using Schwartz formula for sampling, we include in this study 173 children aged 6 to 59 months living in the area of Widou Thiengoly. Bivariate and multivariate analyses were made. Result: Most of children (82.3%) lived on more than 1 hour drive from health facility. For the first instance of therapeutic choice, most of mothers (61.2%) used self –medication in case of children disease, 35.3% of mothers used health facilities and 2.6% choosed traditional healers. For second instance, only 2.4 % of mothers were used self-medication. For third instance, there was no self-treatment. Therapy organizing group were led by mothers at 56.5 % and fathers in 45.6%. At 77.6% of cases, there were discussions to decide on the treatment of the child. In most cases, fathers were interviewed (90.9%) to give their opinion on the therapeutic choice. Fathers paid for children care in 87.6% of cases. 30.6% of mothers said that self-medication was cheaper compared to health facilities and traditional healers. 95.3% said that they believed that it was most efficiency to use a lot of type of therapeutic in same moment. Multilogistic regression found that the quality of the caring relationship impacted in using health services ajOR=0.19: IC=0.056-0.59. Conclusion: This study contributes to the knowledge of self-treatment choices regarding children disease management in Senegal rural area. The main finding of this study was that the quality of the caring relationship impacts attendance and utilization of health services. A professional and competent attitude on the part of health workers will thus be able to improve the use of health services in traditional rural areas in Senegal.
Highlights
In Senegal, the search for care for sick children is intimately linked to intensive home care and low use of health facilities [1]
Fifty-five (55.81%) of children have used the health facility for their care in the last 6 months. 65.88% of children used the health structure during their last episode of illness. 2.34% of children are enrolled in a mutual health insurance scheme. 5.26% received free care in the health facility
Eighty-two percent (82.25%) of the sample take more than an hour to reach the nearest health facility. 74.84% of families are familiar with the health worker working in the health facility
Summary
In Senegal, the search for care for sick children is intimately linked to intensive home care and low use of health facilities [1]. In contemporary black Africa, there is a wide range of therapeutic remedies, ranging from modern medicine to traditional medicines, from the healing cults of JewishChristian and prophetic religions to maraboutic practices. In addition to these types of recourse, there are popular health care practices whose main actors are mothers, fathers, grandmothers and grandfathers, and all drug peddlers (modern or traditional) sold at retail throughout African towns and villages [3].
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