3.0 SOCIAL AND CULTURAL ASPECT OF HEALTH CARE DELIVERY

3.1. Socio-cultural Aspects of Health Care Delivery

Relevance of Culture to Health

i. Culture derives from societal practice, norms, and values, health habits inclusive. 

ii. Cultural practice can enhance or worsen the health status of a people. 

iii. The definition of health and illness of a people can only be understood within their cultural context. 

Some Aspects of Nigerian Culture that are beneficial to Health 

i. Prolonged breast-feeding of babies promotes healthy growth among babies. 

ii. Child spacing is a kind of natural family planning. 

iii. Prolonged cooking of food prevents food contamination and destroys deadly bacterial. 

Some Aspects of Nigerian Culture that are not beneficial to Health 

• Very Hot bath following child birth (wankan-jego)

• Early marriage/teenage pregnancy

• Potassium pap (kunun-kanwa)

• Deep perineal cut (yankan gishiri)

• All forms of Female Genital Mutilation (FGM) and scarification

• Forced feeding and abrupt weaning

• Refusal of early and medical treatment of a febrile or measles patient in the bid that the child is increasing in height and that certain illness forbids injection or defiles hospital management.

• Scarification and sucking out ‘bad blood’, and applying herbs to treat convulsion, splenomegaly, swellings both of arthritis, sickle cell.

• Cutting the umbilical cord with any sharp and unhygienic object and dressing with cow dung.

• Food taboo: Denying children protein e.g. egg. meat, fish, snail

• Consumption of local gin, concentrated tea/coffee without milk and low protein diet to either slim or avoid fattening the baby in-utero.

• Subsequent use of purgatives either as pepper or soap enema for children and other purgative in an attempt to clean the gastro-intestinal tract of “dirt” and clear ill— health.

• Drinking of blue, concoctions and insertion of corrosive and chemical (e.g. lime) substances to prevent pregnancy

• Violence against women

• Child abuse  and child abuse; and 

• Cross-cousins marriage among some ethnic may contribute to congenital malformations. 

3.2. Individual’s Social and Influence on Health Care Delivery

Social factors which tend to encourage or discourage a person in making decision to obtain medical care from seeking medical care include:  

1. age 

2. sex

3. ethnicity

4. economic status and,

5.  education

Illness Behaviour

Illness behaviour is the way an illness is perceived, evaluated and acted upon by those who have the feelings of pain and discomfort. By implication there are variations in the way individuals and groups respond to disease and illness.

Factors that may influence Illness Behaviour 

Effects of group structure

General cultural prescriptions

Concern for financial cost of care 

Fear of the possible outcome of the disease

Stages of Illness Behaviour

1. Symptom experience   

2. Assumption or the sick role   

3. Medical care contact 

4. Dependent-patient role   

5. Recovery and rehabilitation

3.3. Concept of the Sick Role 

Role is a behavior expected of someone who holds a particular status. Role is the dynamic aspect of one’s status: an individual holds a status and performs a role.

Status refers to the responsibilities and benefits that a person experiences according to their rank and role in society.

The concept of the sick role represents the most consistent approach to explaining the behavioural pattern of sick people. Being sick is not a deliberate choice of the sick person even though illness may occur due to exposure to infection or injury. The sick person usually is unable to take care of himself, and this is why it is necessary for him to seek medical advice and cooperate with medical experts. 

The Specific Aspects or Attributes of the Sick Role 

• The sick person is exempt from “normal” social roles

The sick has an exemption from normal role performance and social responsibilities because of the state of his health. Usually, the more severe the illness, the greater the exemption. 

• The sick person is not responsible for his or her condition

A sick person’s illness is assumed to be beyond his or her own control. 

• The sick person should try to get well 

Since being sick is an undesirable condition, the sick individual must have the desire to regain normal health. 

• The sick person should seek medical advice and cooperate with medical experts

The desire to get well by the sick person must inevitably lead to his being desirous to cooperate with the physician and other health workers.