Perceptions of childhood immunisations in rural Transkei - a qualitative study

Objectives. To examine perceptions of childhood illnesses, and the role of immunisation in preventing them, among caretakers of young children in Mhlakulo, a rural community in Transkei, Eastern Cape, and to suggest reasons for the low uptake of immunisations in that area. Design. In-depth qualitative research using semi-structured questionnaires, focus groups, and free listing. Methods. Detailed interviews were conducted using standardised semi-structured questionnaires. Interviews involved 60 caretakers of children aged under 5 years brought to a community health centre. Interviews were followed by two focus groups and free listing interviews to validate results of these questionnaires. Results. There was widespread acceptance of the value of immunisations in preventing childhood illnesses, but only vague knowledge of why they are given, and for what illnesses. The most common knowledge was of measles and polio, but there was only limited knowledge of BCG, DPT and other immunisations. Childhood illnesses were seen as multi-causal in origin, but there was a marked absence of germ theory in explaining them. Attitudes to the use of traditional medicines in childhood were generally negative. Conclusions. Despite positive perception of immunisations, there is widespread ignorance of what they are for, and how they work. This suggests the need for increased health education, more community participation, and organisational changes in primary care clinics to make them more userfriendly to caretakers of infants and young children. S Afr Med J 2004; 94: 835-838

Doença versus Enfermidade na Clínica Geral

Tradução deo artigo "Disease versus illness in general practice", publicado em 1981 pelo The Journal of the Royal College of General Practitioners

Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina

BACKGROUND: The results of a qualitative study carried out in four developing countries (Cuba, Thailand, Saudi Arabia and Argentina) are presented. The study was conducted in the context of a randomised controlled trial to test the benefits of a new antenatal care protocol that reduced the number of visits to the doctor, rationalised the application of technology, and improved the provision of information to women in relation to the traditional protocol applied in each country. METHODS: Through focus groups discussions we were able to assess the concepts and expectations underlying women's evaluation of concepts and experiences of the care received in antenatal care clinics. 164 women participated in 24 focus groups discussion in all countries. RESULTS: Three areas are particularly addressed in this paper: a) concepts about pregnancy and health care, b) experience with health services and health providers, and c) opinions about the modified Antenatal Care (ANC) programme. In all three topics similarities were identified as well as particular opinions related to country specific social and cultural values. In general women have a positive view of the new ANC protocol, particularly regarding the information they receive. However, controversial issues emerged such as the reduction in the number of visits, particularly in Cuba where women are used to have 18 ANC visits in one pregnancy period. CONCLUSION: Recommendations to improve ANC services performance are being proposed. Any country interested in the application of a new ANC protocol should regard the opinion and acceptability of women towards changes

Culture Health and lllness

501 hal.;24 c