Health care seeking behaviour and utilisation of traditional healers in Kalabo, Zambia

• Published in: Health policy (Amsterdam) 2005, Vol.71 (1), p.67-81
• Main Authors: Stekelenburg, Jelle, Jager, Bastiaan E., Kolk, Pascal R., Westen, Esther H.M.N., Kwaak, Anke van der, Wolffers, Ivan N.
• Format: Article
• Language: English
• Subjects: Focus Groups; Healers; Health administration; Health care; Health care seeking behaviour; Health Services Needs and Demand; Humans; Kalabo; Medical sector; Medical service; Medicine, African Traditional; Medicine, Alternative; Patient Acceptance of Health Care; Patient Satisfaction; Public health; Traditional healing; Traditional medicine; Utilisation; Western Province, Zambia; Zambia
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2004.05.008

Objective: To identify traditional healers in the catchment area of Kalabo District Hospital and to investigate determinants which play a role in the choice between different health care options, and to explore possibilities for increasing co-operation between the District Hospital and traditional healers. Methods: In a cross-sectional comparative and descriptive study, a combination of both quantitative and qualitative methods was used. A total of 12 health workers, 13 traditional healers and 100 community representatives were interviewed, using (semi)-structured questionnaires. A focus group discussion was held with 12 traditional healers. Results: This study shows that all respondents are willing to visit the hospital if they fall ill in future, and 88% of the respondents will visit a traditional healer. More women than men visit traditional healers, but the men who do visit them, do so more frequently. Level of education is not an important determinant. Increasing age leads to more frequent visits to both the hospital and traditional healers. Almost half of the respondents (49%) only have to walk less than 30 min to a traditional healer, but the hospital is the same distance for only 34% of the respondents. Waiting time turned out to be an important factor: in the hospital, 48% of the respondents are not helped within time, and only 28% are not helped in time by the traditional healer. Demon possession, mbaci, kanono and infertility are typical health problems for which people visit a traditional healer. The cost of treatment from a traditional healer is usually one cow, but only if the patient is cured. Satisfaction was measured at 89% after hospital treatment, and 74% after treatment from a traditional healer. If dissatisfied with the traditional healer, 86% would consider attending the hospital.