The use and non-use of preventive health services in a southern African village.

Qualitative data from the survey and intensive interviews revealed that women were confused between curative and preventive health measures, consistent with the finding that few used the clinic delivery service: most women saw no reason to seek professional help in the absence of perceived problems.

Abstract

This study investigates the relationship between the health beliefs of mothers in a Botswana village and their utilization of available maternal and child health resources, specifically immunizations, antenatal care, and clinic delivery. The two-pronged methodology includes (1) a household survey of 620 mothers of children under the age of five and (2) a series of intensive but informal, loosely structured interviews with 19 village women. Results show that a majority of the children had received one immunization but that few had ever had more. Most of their mothers had attended the antenatal clinic, but fewer than 30% had made use of the village maternity service in childbirth. As predictors of these kinds of preventive behaviour, mother's age, education, use of the radio, participation in voluntary women's organizations, and material consumption were, for the most part, unimpressive. On the other hand, qualitative data from the survey and intensive interviews revealed that women were confused between curative and preventive health measures. Few respondents linked immunization with prevention of specific diseases; half the women expressed concern that the immunizations were dangerous, while others indicated lack of knowledge about the desired number; still others believed that immunizations "made the children grow". As for maternity services, the majority of women who attended the antenatal clinic had actually done so for a somatic complaint. They were responding to their perception of the clinic as a place that cures, rather than prevents, illness. This was consistent with the finding that few used the clinic delivery service: most women saw no reason to seek professional help in the absence of perceived problems. The authors point out implications of this study for community-centred, in contrast to disease-centred, health education.