Health Seeking Behaviour of the Rajbanshi Community : in Baijanathpur and Katahari of Morang Nepal, Volume 2

By Subba, Nawa Raj

Book Id: WPLBN0100304391
Format Type: PDF eBook:
File Size: 0.1 MB
Reproduction Date: 3/9/2023

Title:	Health Seeking Behaviour of the Rajbanshi Community : in Baijanathpur and Katahari of Morang Nepal, Volume 2
Author:	Subba, Nawa Raj
Volume:	Volume 2
Language:	English
Subject:	Non Fiction, Medicine, Public Health
Collections:	Authors Community, Medicine
Historic Publication Date:	2023
Publisher:	Hamro Idea

Member Page:	Nawa Raj Subba
Citation APA MLA Chicago Raj Subba, B. N. (2023). Health Seeking Behaviour of the Rajbanshi Community : in Baijanathpur and Katahari of Morang Nepal, Volume 2. Retrieved from http://gutenberg.cc/

Description
The research on Rajbanshi ethnicity's health-seeking behaviour provides a window into Nepal's public health. This Rajbanshi ethnicity is one of the indigenous people of Nepal and is involved in modern and traditional medical practices. It also captures Nepal's entire ethnic diversity. The public health and development field has read and supported this study, conducted almost two decades ago, with great interest. I once more revised this study material like a master's thesis. I made grammatical corrections to it. To improve the presentation, I made some adjustments. I hope this research will mark a turning point in the study of public health, social development, and culture, providing a foundation upon which future research into and evaluation of this community or region will be meaningful. This author is still researching the Rajbanshi people's social and public health. After a certain period, the goal is to conduct a comparative study based on the findings of this study. As a result, this material may be helpful to both the reader and the researcher. With this in mind, I've included some of the revised second rites generally edited in the first edition.

Summary
Nepal is a country of multi-cultural, multi-religious, multi-lingual, pluralistic and mosaic society. Ethnic communities have their distinct healing practices. It has been widely felt that access to modern medication in rural and urban communities is very low; despite the service, the government has made outlets available even at the periphery level. Health Care practices - Modern, Traditional, Self-medication, and Alternative are existed in almost every community and are an indispensable part of our health system. Merely establishing Sub-Health Posts and training for Health Workers cannot ensure access to health services and also requires an attempt on the Socio-economic assessment and cultural and behavioural diagnosis. Rajbanshi is one of the ethnic groups living in Nepal's Morang and Jhapa districts. Their estimated population is fairly above 0.1 million (CBS, 1991). This study was an exploratory, descriptive, cross-sectional, and qualitative study based on a household survey. The study has assessed the disease prevalence, healing or caring practices and determinants of health-seeking behaviour. This study was undertaken in two Village Development Committees (VDC) of Morang district in 2001 with the Specific objectives of: (1) to discover the practices of using traditional and modern medicine in the community. (2) Assess the satisfaction and dissatisfaction with traditional medicine, modern medicine, or health services. (3) Assess the expenses on health care. (4) Know various self-care methods and types of therapy consumers use. Attempts to make 175 household visits were made by the head of the households, particularly as respondents of the study. A Rajbanshi graduate and one more interviewer were trained before going to the community. With the help of these two-trained interviewers, the researcher carried out interviews and conducted Focus Group Discussions. Major findings Rajbanshi ethnic in Katahari and Baijanathpur VDC were found to have a literacy rate of 65% in the sample taken. The principal occupation is agriculture. Most people fall in the category of having no land to less than 2 bighas. The average family size is 5.76 persons. Attempts to interview mostly heads of the 175 households were made in two VDCs. And there were 61% of males and 39% of females reported sick. A proportion percentage of the common type of ailments was reported, such as headache, body aches, weakness (50.8) and then ARI (44), fever (30.8), Eye/ENT(18.8), and diarrhoea (13.7) were reported respectively. The distribution of reported illness was highest among those over 66 years of age than among 55-65 and 46-55, respectively. People were found adopting Modern medication, Self-medication and Alternative-medication. Dhami Jhakri/Shaman, retailers were common practices under self-medication. 72.0% of patients used private clinics, whereas only 15.4% had used health post-service. Poor were adopting self-medication higher than other economic strata were found to be statistically significant (P=0.0160). Similarly, the rich were adopting alternative medication more than the poor, which was statistically significant (P=0.0000). Uneducated people used self-medication more than educated, which was statistically highly significant (P=0.0000063). The average treatment cost is Rs. 1031.64 (SD=6). 73.1% of patients were reported as unable to afford the expenses for treatment. They had taken either loans (14%) or had to sell land, animals, grains or personal belongings (53%). The bulk proportion (57.8%) of expenses fell on buying drugs and fees (19.55%). After that, for transportation, 5%, helpers 3.74%, and others 13.84%. Therefore, the concern about the unaffordability of treatment costs for modern medication is striking. Utilization of PHC services: They were found familiar with going to EPI-Camp (79.4%) to get a vaccination for their children. They are also familiar with FCHV and recognize her services. Most people know their FCHV (50.2%) and used to take service from her. On the other hand, more than 89.2% population was found still unknown to MCHW, TBA and PHC-ORC and its services. Cost: The proportion of people paying between Rs.51-200 was 39% of the sample. But the average expenditure per patient was Rs. 1031.64 (i.e. mean, and SD=6) for a treatment. It is unaffordable for 73.2% of people, so they take loans or sell their belongings for treatment. Most of their expense goes to buying drugs and paying fees. The rest portion was expensed for transportation, helper cost, and others. Satisfaction: Rich were found satisfied with alternative medicine, which was found statistically significant (0.0050). Educated patients were also satisfied with an alternative medication, which was statistically significant (P=0.0000). Recommendations Based on the findings, the following recommendations could be made as follows: Since the majority of the poor people go for self-medication and the private clinic was perceived to be expensive, the personnel of the self-medication or service providers such as Dhami/ Jhakri/ Shaman, the retailer need to be oriented on a referral system. Since 73.2% of people cannot afford treatment, free mobile health camps should be provisioned for the poor. Since 89.2% of the population was unknown to MCHW, TBA and PHC-ORC services, training and awareness programs should be given to service providers and users.

Excerpt
The conclusions are drawn from the study's objective, findings, and analysis. 1. The major occupation of Rajbanshi in Katahari and Baijanathpur was agriculture. And others were labour-work, business, service etc. 2. Most people fall in the category of having no land to less than 2 bighas. A common type of ailments was reported, such as headache, body aches, weakness (50.8) and then ARI (44), fever (30.8), Eye/ENT(18.8), and diarrhoea (13.7) were reported, respectively. The distribution of reported illness was highest among those over 66 years of age than among 55-65 and 46-55 years of age, respectively. 3. People were found using Modern medication equally. Higher use of Self-medication by the poor was significant (P=0.0160). Similarly, higher use of alternative medication by the rich was statistically highly significant (P=0.0000). 4. The literacy rate in the sample was 65%. Among Rajbanshi samples, 29% were educated (above SLC). Uneducated people using more self-medication were found statistically highly significant (P=0.0000063). 5. More than 90% of Rajbanshi in these two VDCs had modern health facilities within 30 minutes of distance. Utilization of PHC services: They were found familiar with going to EPI-Camp (79.4%) to get a vaccination for their children. Half of the people know their FCHV (50.2%) and take service from her. On the other hand, more than 89.2% population was found still unknown to MCHW, TBA and PHC-ORC and its services. 6. Self-medication- Dhami/Jhakri/Shaman were the main service providers of Self-medication. They used to Phukphak, worship, and sacrifice 62.4%, 80.4%, and 14.2%, respectively. Retailers and herbal were also common in this community. 7. Causes: People were mostly guided by their perceived satisfaction (82.8). Other determinants of choosing certain practices were distance, custom, cost etc. Family members and self-knowledge played the driving role in deciding the possible options. 8. Visits: Most patients go more than once to take health care, and their second visits provide significant satisfaction. 9. Cost: The proportion of people paying between Rs.51-200 was 39% of the sample. But the average expenditure per case was Rs. 1031.64 (i.e. mean, and SD=6) for a treatment. It was reported unaffordable for more than 73% of people, so they take loans or sell their belongings to accomplish the treatment. Most of their expenses go to buying drugs and paying fees. The rest portion expensed for transportation, helper cost and others. 10. Satisfaction: Rich was satisfied with alternative medicine, which was statistically significant (0.0050). Educated was found satisfaction with alternative medication was highly significant (P=0.0000).

Table of Contents
Health Seeking Behaviour of the Rajbanshi community in Baijanathpur and Katahari of Morang Nepal ii SECOND EDITION iv SUMMARY v Abbreviations viii List of Tables ix List of Figures ix Table of Contents x ACKNOWLEDGEMENTS xiii CHAPTER – I INTRODUCTION 1 1.1.Introduction and Background. 1 1.2.Statement of Problem 3 1.3. Rationale of the problem. 5 CHAPTER- II LITERATURE REVIEW 9 2.1 Global Situation. 9 2.2 Studies related to health-seeking behaviour in Nepal. 17 CHAPTER-III METHODOLOGY 21 3.1. Based on Education: 21 3.2. Based on Economic status 22 3.3. Distance of Health Institution 23 3.2 Variables. 23 3.3. Operational Definitions of the Variables. 24 3.4 Conceptual Framework (For qualitative analysis). 25 3.5 Research Questions. 25 3.6 Limitations: 26 3.7 Objectives. 26 Specific Objectives: 26 3.8. Study Design. 26 3.8.1 Study Area. 27 3.8.2 Study Population. 27 3.8.3 Sample Size. 27 3.8.4 Process: 27 3.8.5 Instrumentation. 28 3.8.6 Data collection procedure. 28 3.8.7 Ethical Consideration. 28 3.8.8 Data generation, data storage and data safety procedure. 28 3.8.9 Data Processing. 29 3.8.10 Analysis. 29 3.8.11 Interpretation. 29 3.8.12 Discussion. 29 3.8.13 Write-up. 29 3.9. Relevancy and Applicability 29 3.10 Validity and Reliability of the Tools. 30 CHAPTER IV FINDINGS 31 4.1 Economic Condition 31 4.1.1 Occupation 31 4.1.2 Land 31 4.2 Economic Condition and Sickness. 32 4.2.1 Sickness by Economic Condition 32 4.3 Education and Sickness 33 Education. 33 Education and Medication. 34 4.4 Distance of Modern Health Facilities and trend 34 4.5 Reported Illness. 35 4.5.1 Morbidity by Sex. 36 4.5.2 Use of PHC-Services. 36 4.5.3 Use of Health Care System. 37 4.5.4 Types of Modern Health Services 37 4.5.5 Categories of Self-medication 38 4.5.6 Alternative Medication. 41 4.5.7 Causes of taking Services. 43 4.6 Referral System 43 4.6.1 Advice for Referral 43 4.6.2 Frequency of Visits. 44 4.7 Satisfaction 44 4.7.1 Satisfied clients number 44 4.7.2 Expenses for Treatment. 45 4.7.3 Affordability. 46 4.7.4 Cost Bearing 46 4.7.5 Satisfaction. 47 4.7.6 Satisfaction with investigation 47 4.7.7 Usual Visit to Take Care. 48 4.7.9 Satisfaction with medication based on Education. 50 4.7.10 Satisfaction from medications based on economic status. 50 4.8 Findings from Focus Group Discussion 51 CHAPTER V DISCUSSION 56 CHAPTER VI CONCLUSION 59 5.2 Recommendations: 60 References 61 Appendix 64 About Author (updated) 73