37. Among the interviewed respondents, 89.7% opted for "holy water or talisman" as the traditional/folk remedy of abortion, whereas 79.3% depends on the "exorcism and different religious rites" as the traditional remedy for the same. Again 37.9% stated on behalf of "ingesting herbal extracts/Kabiraji /salsa" as the remedy. However, 48.3% opted for alarming "heals spontaneously"! These are results of the traditional beliefs possessed by the rural population and also reflect the lack of knowledge in the context within the community. Also lack of availability of the service options in the community worsens the situation.
The abortion is a comparatively complicated situation in social or medical contexts. Socially in the rural Bangladesh this is like a forbidden issue, a taboo or prohibited issue which can’t be discussed normally. For the reasons, modern knowledge and health care practices about the abortion couldn’t be disseminated in the rural community and thus the abortion remains vulnerably medieval! Thus, we can see abundance of the rituals to satisfy supernatural powers to get rid of it! Since last decade, family planning services are often discussed in the rural community of Bangladesh, however, no such discussions or counseling on abortion is still lacking. It can be mentioned that, Bangladesh’s on of the major development partner and donor USAID never donates money in any project where there is plan for abortion! But abortion is seen as a must in a society (whatever the number of percentage!) and has been practiced in every community since the inception of the human civilization including the rural Bangladesh! So, if any one wants abortion for medical or social causes, so option is present in the community. Most of the religious leaders of Islam in the rural Bangladesh deny family planning or contraception, a known reason is contraception may obstruct or even diminish the chance for Emam Mahdi to be born in the earth for salvation of the human races! In this way, the abortion remains one of the most forbidden issues among the population.
Traditional/folk treatment for Abortion
Pct of Pct of
Count Responses Cases
Exorcism/religious rites 276 30.3 79.3
Holly water/talisman etc. 312 34.2 89.7
Heals spontaneously 168 18.4 48.3
Others 24 2.6 6.9
Ingesting herbal extracts/Kabiraji /sals 132 14.5 37.9
------- ----- -----
Total responses 912 100.0 262.1
38. Among the interviewed respondents, 72.4% opted for "eating rice with herbal preparation’ and also another 69% described "ingesting herbal extracts/elixirs" as the traditional/folk remedy of jaundice. "Exorcism/religious treatment" as the remedy of jaundice opted by 51.7% respondents, whereas, 37.9%, 24.1% and 37.9% informed of "bathing under supervision of a holly man", "applying herbal pulp on the body and head" and "wearing sanctified talisman/necklace/wristband" respectively as the traditional or folk remedy of jaundice. Whereas, the scientific approach "ingesting sugar cane juice" practiced as remedy of jaundice by only 3.4%.
-Jaundice still remains as a most mysterious disease among the rural population in Bangladesh. It is important to see that the health care behaviors are mostly practiced in the line of the perceived etiology of the diseases. For jaundice, many myths and descriptions are prevailing in the rural community and those are all very strongly embedded in the traditional and indigenous beliefs of the rural population. Even the educated people also have certain degree of superstitions. For Jaundice, the prevailing superstitions are much more in numbers, so in this finding, we observe the various remedy procedures.
Traditional/folk treatment for jaundice
Pct of Pct of
Count Responses Cases
Exorcism/religious treatment 180 17.2 51.7
Eating rice with herbal preparation 252 24.1 72.4
Ingesting herbal extracts/elixirs 240 23.0 69.0
Wearing sanctified talisman/necklace/wris 132 12.6 37.9
Applying herbal pulp on the body and hea 84 8.0 24.1
Others 12 1.1 3.4
Bathing under supervision of a holly man 132 12.6 37.9
Ingesting sugar cane juice 12 1.1 3.4
------- ----- -----
Total responses 1044 100.0 300.0
39. Among the interviewed respondents, 96.6% described the traditional or folk remedy of hysteria through "exorcism/religious treatment/religious rite", whereas, 86.2% stated the remedy as "through use of "holly water/talisman etc." Curiously interesting that 48.3% opted for "smelling burn chilly in the nostrils" as the remedy for hysteria. Again 6.9% described the remedy as "goddess Kali's worship"! Whenever there is knowledge gap in any issue in the community and also the flow of knowledge in the issue is not available, , traditional beliefs and the myths become the only means through which the rural population describe the issue.
-Like Jaundice, hysteria also have varieties of etiologies and the remedy procedures also follow those, but only difference is the hysteria is much less known among the rural population and in almost all the instances, it is referred to the phenomenon of "possession" by the nymphs!
Traditional/folk treatment for hysteria
Pct of Pct of
Count Responses Cases
Exorcism/religious treatment/religious r 336 32.2 96.6
Holly water/talisman etc. 300 28.7 86.2
Smelling sole of the footwear 60 5.7 17.2
Smelling burn chilly in the nostrils of 168 16.1 48.3
Drinking herbal extracts/elixirs 72 6.9 20.7
Heals spontaneously 84 8.0 24.1
Through goddess Kali's worship 24 2.3 6.9
------- ----- -----
Total responses 1044 100.0 300.0
40. Among the interviewed respondents, 75.9% described "exorcism/religious treatment" as the traditional remedy for mental retardation. Again another 82.8% opted for the use of "holly water/talisman" as the traditional or folk remedy for mental retardation in the rural Bangladesh. Remedy through spontaneous process had been described by 51.7% of the respondents. "Kali sadhan or special rite to satisfy the nymphs had been prescribed by 6.9%, whereas, 17.2% opted for praying to Allah/God for the remedy. Here also the knowledge gap is the determinant of the evolvement of the story and myths depending upon the traditional beliefs and other old myths.
-Like hysteria, mental retardation is also very rarely known, having various perceived etiologies and the remedy or health care behaviors follow those etiological pathways!
Traditional/folk treatment for mental retardation (Multiple Response)
Pct of Pct of
Count Responses Cases
Exorcism/religious treatment 264 27.8 75.9
Holly water/talisman 288 30.4 82.8
Heals spontaneously 180 19.0 51.7
Others 84 8.9 24.1
Pray to Allah (God) for remedy 60 6.3 17.2
Don't know 48 5.1 13.8
Through goddess Kali's worship (Kali-sad 24 2.5 6.9
------- ----- -----
Total responses 948 100.0 272.4
41. Among the interviewed respondents, 79.3% stated that they feel ashamed to be treated (going to doctor, telling to the family members about the disease etc. The feelings evolve from the thinking that the spending of money for him/her for treatment, will worsen the family economic condition (as they are poor). Also if he was income earning, his family will be deprived from his earning when diseased. Even if the family is solvent, still the diseased individual becomes ashamed as she/she is causing extra burden to the family.
-Shame is frequently associated with the feelings of "guilt" and the stigma and in the case of health care behaviors; it is the feeling of guilt and stigma due to be diseased which predisposes to their health care behavior.
| Shyness to be treated |
|
| Frequency |
| Valid Percent |
|
| Feel shy to be treated | 276 |
| 79.31 |
|
| Don't feel shy to be treated | 72 |
| 20.69 |
|
| Total | 348 |
| 100.00 |
|
42. Among the interviewed respondents, 89.7% feel guilty if diseased/possesses stigma if diseased. As stated earlier, factors existing in the community oblige the diseased to feel stigma and guilt.
-As it discussed previously, this feelings of "guilt" or stigma can predisposes to the built of their health care behaviors.
| Feelings of guilt if diseased |
|
| Frequency |
| Valid Percent |
|
| Feels guilty if diseased/possesses stigma | 312 |
| 89.66 |
|
| Don't feel guilty if diseased/not possessing stigma | 36 |
| 10.34 |
|
| Total | 348 |
| 100.00 |
|
43. Among the interviewed respondents 68.97% believed the disease as the punishment from the Allah/God. This is anther example of the combined effect of poverty, lack of education and possessed traditional beliefs.
-Another important finding which is capable of forming their health care behaviors. Some times when diseased, whether they will stick for the remedy procedures through treatment or becoming reluctant to variable degrees depend upon their beliefs how the diseases are evolved.If it is seemed to be a godly affair, then human has naturally to do little in the context!
It reflects the traditional beliefs of the population. Education and poverty (as the any treatment requires money) also play major role in the context.
| Believes disease as the punishment from the God |
|
| Frequency |
| Valid Percent |
|
| Think the disease as the punishment from God | 240 |
| 68.97 |
|
| Don't think disease is the punishment from God | 108 |
| 31.03 |
|
| Total | 348 |
| 100.00 |
|
44. Among the interviewed respondents, 93.1% described "ingesting rotten/decomposed/ contaminated" as the etiology of diarrhoea/Cholera/Bhedbami, whereas, 51.7% informed of "if anybody special watches pt. to eat" as the etiology of diarrhoea/Cholera/Bhedbami. Curiously interesting "anger of scheduled local goddess Ola/Obba" and "Eating in odd time" had been suggested by same proportions of the respondents (34.5% for the both) and respectively. "Night/noon traveling after eating palm cake" was stated as the cause by 31%.
This is a typical example how the traditional beliefs and modern knowledge compromises with each other as we find response from disseminated modern knowledge and possessed traditional beliefs. Traditional beliefs are the determining factors in the context. Again this is a typical example how the traditional beliefs can affect the mind of the individuals and influence his health seeking behavior.
-Here the etiologies perceived by the respondents for diarrhoea/Cholera/Bhedbami and are dominated by the traditional beliefs with the elements of religious and local myths. Although we saw in previous discussions that they are in favor of practicing replenishing fluids and electrolytes as the positively changed health care behavior.
Etiology of diarrhoea/Cholera/Bhedbami
Pct of Pct of
Count Responses Cases
Ingesting rotten/decomposed/contaminated 324 32.5 93.1
Eating food prepared with contaminated/a 96 9.6 27.6
If anybody special watches pt. to eat or 180 18.1 51.7
Traveling in night or noon after eating 108 10.8 31.0
Eating in odd time 120 12.0 34.5
Viewing mysterious cat/dog in night whil 48 4.8 13.8
Anger of scheduled Hindu goddess Ola 120 12.0 34.5
------- ----- -----
Total responses 996 100.0 286.2
45. Among the interviewed respondents, all (100%) described "getting cold" as the etiology of respiratory infection. "Becoming wet in rain/exposed to open space" and "Staying with a patient of cold/cough" both were described as the etiologies by 72.4% of the respondents for the same.
-This finding expresses their perceptions about the etiologies of respiratory infections and their health care behaviors usually follow the routes of the etiologies perceived.
Etiology of pneumonia
Pct of Pct of
Count Responses Cases
If got cold 348 38.7 100.0
Becoming wet in rain/exposed to open spa 252 28.0 72.4
Staying with a pt. with cold/cough 252 28.0 72.4
Others 48 5.3 13.8
------- ----- -----
Total responses 900 100.0 258.6
46. Among the interviewed respondents, 79.3% described going to "bad" places/coitus with prostitute or unknown person as the etiology of reproductive tract infection and sexually transmitted disease. About 51.7% informed of "sexual partner/self/staying unclean/dirty" as the etiology of the same. Considerable high percentage of respondents expressed their various superstitions as the etiology of reproductive tract infection and sexually transmitted infection (table). Here we see, they have some correct and some incorrect information. Correct one is the results of the modern information dissemination in the community and the incorrect one is usually from their indigenous traditional beliefs.
-This finding reflects the perceptions of the respondents regarding the Reproductive tract Infections (RTI) and the Sexually Transmitted Diseases (STD) and those are the mixtures of the facts and the fictions!
Etiology of RTI/STD
Category label
Pct of Pct of
Count Responses Cases
Sexual partner/self/staying unclean/dirt 180 17.2 51.7
Going to/coitus with "bad" places/prosti 276 26.4 79.3
Accompany of RTI/STD pt. 72 6.9 20.7
Wearing dresses of an pt./using pt. bed 48 4.6 13.8
Using a common urinal 36 3.4 10.3
Wet genitalia 144 13.8 41.4
Coitus with women in menstruation 144 13.8 41.4
Too much coitus 144 13.8 41.4
------- ----- -----
Total responses 1044 100.0 300.0
46. Among the interviewed respondents, 72.4% claimed "coitus in pregnancy/repeated coitus". "Eating/drinking/herbal foods/extracts" and Inflicted with unseen influence of black magic", both stated by 51.7% of the respondents as the etiologies of abortion in rural Bangladesh. Claims like "Eating pineapple/leaf/papaya/carrot" had been described respectively by 41.4% respondents. This finding also describes the traditional beliefs of the population; also lack of effective information flow is marked. It is also reflecting their century old knowledge about the use of pineapple leaf, papaya, carrot which can ease abortion due to the pharmacologic components within.
-Reflecting the respondents’ perceptions for the etiologies of the abortion and those are also a mixture of facts and fictions as mentioned above.
Etiology of abortion
Category label
Pct of Pct of
Count Responses Cases
Eating/drinking/herbal foods/extracts/el 180 17.2 51.7
Inflicted with unseen influence of black 180 17.2 51.7
Staying unhealthy 84 8.0 24.1
Coitus in pregnancy/repeated coitus 252 24.1 72.4
"Bad" thinking in pregnancy 24 2.3 6.9
Traveling in old shrines/lonely places 72 6.9 20.7
Traveling in "bad" time (in dawn/dusk) 60 5.7 17.2
Early marriage/late marriage/early/late 48 4.6 13.8
Eating pineapple/pineapple leaf/papaya/ca 144 13.8 41.4
------- ----- -----
Total responses 1044 100.0 300.0
47. Among the interviewed respondents, 79.3% and 72.4% claimed etiology of jaundice as "possession by scheduled goddess" and "black magic/ban or witchcraft or deploying evil power" respectively. Staying in the wet places", "Ingestion of excessive turmeric in food/working in the turmeric field", "attending turmeric day in a marriage ceremony" etc described as etiology by appreciable percentage of respondents. In this finding knowledge gap is evident in the rural community. No respondent, regardless their economic condition could tell about the modern knowledge for the jaundice. However, even most described, jaundice remained as the least clarified syndrome till date in Bangladesh as even the educated people rarely can tell its etiology (the etiology supported by the modern science is also very much complicated to describe). So when there is gap in knowledge, myths appear through the interested quarters and even the educated people submit themselves under the disposal of the traditional healers who disseminate the myth to earn his income earnings.
-In the same way, the respondents’ perceptions on the etiologies of the Jaundice were explored and seen as totally a confused issue. They have variable understandings regarding the etiologies of the Jaundice and unfortunately their health care behaviors are always guided by the etiological perceptions prevailed!
Etiology of jaundice
Category label
Pct of Pct of
Count Responses Cases
Possession by scheduled goddess couple/" 276 28.4 79.3
Black magic/ban/witch craft/deploying ev 252 25.9 72.4
Ingestion of excessive turmeric in food 96 9.9 27.6
Eating rotten/decomposed/day old food/dr 24 2.5 6.9
Repeated work in turmeric field 72 7.4 20.7
Attending turmeric day in a marriage cer 24 2.5 6.9
Others/staying in wet place 120 12.3 34.5
Lack of vitamins 60 6.2 17.2
Don't know 36 3.7 10.3
Eating egg in fever 12 1.2 3.4
------- ----- -----
Total responses 972 100.0 279.3
48. Among the interviewed respondents, 75.9% and 72.4% claimed "possession by spirit of dead died unnaturally" and "possession by supernatural/evil power" respectively as the etiology of hysteria. All the responses seemed to be linked with their traditional myths.
Hysteria is another disease still thought with varieties of myth. As the females are sufferer, the traditional healers and the family elders in the rural areas usually describes it as a disease inflicted by the supernatural powers. The main factors are the traditional beliefs, lack of education and also the poverty. Information gap is the determinant.
-Perceived etiologies for the hysteria are responsible for their health care behaviors in response to this disease and it is seen that all the perceived etiologies are related with supernatural myths prevailing in the rural Bangladesh.
Etiology of hysteria
Category label
Pct of Pct of
Count Responses Cases
Possession by supernatural/"evil" power 252 24.1 72.4
Possession by the spirits of dead died o 264 25.3 75.9
Black magic/witch craft/deploying evil f 96 9.2 27.6
Caught by bad wind containing evil power 228 21.8 65.5
Fed with unconventional meat (vulture,crow) 60 5.7 17.2
Going outside in kali goddess night 144 13.8 41.4
------- ----- -----
Total responses 1044 100.0 300.0
49. Among the interviewed respondents, 58.6% and 48.3% claimed "possessions by supernatural/"evil" power" and "black magic/witch craft/deploying evil force" respectively as the etiology of mental retardation. Mythical "going outside in kali goddess night (Kali puja)" claimed by 37.9% as the etiology of mental retardation. It is surprising that very few admitted that they did not know the scientific etiology and nobody were reluctant to tell something as etiology of "mental retardation". Traditional beliefs are the important factor for the perceptions.
-All the etiologies perceived by the respondents for mental retardation are related with popular myths or legends and are far from the modern conceptions. Health care behaviors in response to this disease so follows the etiological causes!
Etiology of mental retardation
Category label
Pct of Pct of
Count Responses Cases
Possession by supernatural/"evil" power 204 22.1 58.6
Possession by the spirits of dead died o 168 18.2 48.3
Black magic/witch craft/deploying evil f 168 18.2 48.3
Caught by "bad wind" containing evil pow 12 1.3 3.4
Fed with unconventional food (vulture,cr 156 16.9 44.8
Others 24 2.6 6.9
Going outside in kali goddess night 132 14.3 37.9
Don't know 60 6.5 17.2
------- ----- -----
Total responses 924 100.0 265.5
50. Among the interviewed respondents, 82.8% claimed the etiology as "fed with unconventional meat (of vulture, crow, fox etc)" and 69% claimed "possession by supernatural/"evil" power" as the etiology of madness. "Possession by the spirits of dead died" comes here as etiology stated by 55.2% respondents." Black magic/witch craft/deploying evil" and "Going outside in kali goddess night (Kali puja)" claimed by 44.8% and 31% respondents respectively as the etiology of madness. Here also the traditional beliefs are important factors.
-Perceived etiologies of the "madness" are described by the respondents in this findings and are all subjected to the popular myths, legends and tales prevailing in the community and too far from the modern conceptions and thus unfortunately their health care attitudes are formed in the relation of the etiologies perceived.
Etiology of madness
Pct of Pct of
Category label Count Responses Cases
Possession by supernatural/"evil" power 240 23.0 69.0
Possession by the spirits of dead died o 192 18.4 55.2
Black magic/witch craft/deploying evil f 156 14.9 44.8
Caught by "bad wind" containing evil pow 36 3.4 10.3
Fed with unconventional food (vulture,cr 288 27.6 82.8
Others 24 2.3 6.9
Going outside in kali goddess night 108 10.3 31.0
------- ----- -----
Total responses 1044 100.0 300.0
51. Among the interviewed, 89.7% sated for the both "harm by different religious/spiritual rite" and "harm through witchcraft" as the etiology of "Ban"! About 79.3% respondents claimed and justified etiology of their "ban" respectively as "black magic with hair, nail/cloth of victim".
-Similar to their own terminology of the "Ban", their perceptions on its etiologies are also all local myths, tales and legends. Here we see the presence of the medieval "witchcraft" and magic/counter magic conceptions related with the etiologies of the diseases!
Etiology of "Ban"
Pct of Pct of
Category label Count Responses Cases
Doing harm through different religious a 312 29.9 89.7
Fed with unconventional food(vulture, kite 144 13.8 41.4
Doing harm through witchcraft 312 29.9 89.7
Black magic with hair, nail/cloth of vic 276 26.4 79.3
------- ----- -----
Total responses 1044 100.0 300.0
52. Among the interviewed respondents, 100% and 89.7% claimed "doing harm by religious/ kali goddess rites" and "Black magic with hair, nail, cloth of victims" respectively as the etiology of black magic. Interestingly, 6.9% and 3.4% described the etiology for the same as "others" and "impelling a doll for the victim (Voodoo)" respectively which resemble closely with West Indian or African Voodoo black magic.
-"Black magic" is affecting the health as perceived by most of the rural population studied and all the perceived etiologies are related with magic and counter magic businesses! Here we observe similarities between our rural "black magic" with African and West Indian Voodoo magic, at least in the procedures.
Etiology of "black magic"
Pct of Pct of
Category label Count Responses Cases
Doing harm by religious/rites/kali godde 348 50.0 100.0
Black magic with hair, nail, cloth of vi 312 44.8 89.7
Others 24 3.4 6.9
Through impelling a doll in name of victim 12 1.7 3.4
------- ----- -----
Total responses 696 100.0 200.0
53 Among the interviewed respondents, 72.4% and 58.6% claimed "travel in inappropriate places in odd time" and "night travel through the place of cremation" respectively as the etiology of the "evil air". Goddess Kali again blamed for 41.4% response as the etiology of "evil air"!
-The respondents’ perceived phenomenon of "bad air" or "evil air" and the perceived etiologies underlying have been found in this findings.
Etiology of "evil air"
Pct of Pct of
Category label Count Responses Cases
Travel in inappropriate places in odd ti 252 24.4 72.4
Travel under big trees or through jungle 49 4.7 14.1
Travel through the place of cremation o 204 19.7 58.6
Travel in night with palm cake or fish 144 13.9 41.4
Going behind the house in night or odd t 120 11.6 34.5
Traveling near the grave of a person die 120 11.6 34.5
Going out in the Kali/charak puja night 144 13.9 41.4
------- ----- -----
Total responses 1033 100.0 296.8
54. Among the interviewed respondents, interestingly 62.1%, 65.5% and 34.5% claimed etiology of "fearfulness" as "being afraid by any means", "going outside or travel in night of new moon" and "seeing cat or dog in village road or bush in night" respectively. Goddess Kali puja night scored 37.9% response among the people of all religion in rural area of Bangladesh.
The respondents’ perceived phenomenon of "fearfulness" and the perceived etiologies underlying have been found in this findings.
Etiology of "fearfulness"
Pct of Pct of
Category label Count Responses Cases
Through being afraid by any means 216 21.7 62.1
To go outside or travel in night of new 228 22.9 65.5
Seeing a cat or dog in road or bush invi 120 12.0 34.5
Travel in inappropriate places in odd ti 48 4.8 13.8
Travel under big trees or through jungle 24 2.4 6.9
Travel through place of cremation of de 108 10.8 31.0
travel in night with palm cake or fish 48 4.8 13.8
Going behind the house in night or odd t 36 3.6 10.3
Travel near the grave of a person died o 36 3.6 10.3
Going out in the Kali/Shyama puja night 132 13.3 37.9
------- ----- -----
Total responses 996 100.0 286.2
55. Among the interviewed respondents, about 41.4% and 37.9% opted for "quack/non-M.B.B.S. private doctors" and "private M.B.B.S. doctors" respectively for treatment if have sufficient money. Interestingly "government hospitals" accounted for only about 10.3% respondents reflecting rural people’s attitude to these outlets.
-This finding expressed their choice of treatment outlets if they were provided with sufficient money! It is interesting to observe that they opted for relatively modern treatments whatever they perceived like MBBS and non-MBBS paramedics. This finding again expresses the respondents’ one of the main constraints for planning their health care behaviors in response to any health ailment.
| Choice of treatment if have sufficient money |
|
| Frequency |
| Valid Percent |
|
| Government hospital | 36 |
| 10.34 |
|
| Private M.B.B.S. doctors | 132 |
| 37.93 |
|
| Quack/non-M.B.B.S. private doctors | 144 |
| 41.38 |
|
| Homeopath/Kabiraji/traditional healers | 36 |
| 10.34 |
|
| Total | 348 |
| 100.00 |
|
56. Among the interviewed respondents, 82.8% and 79.3% informed of the disease cured by Allah/God’s wish and through proper treatment respectively. About 31% described healing spontaneously indicating misconception related to grave public health risk.
-This finding informed us the respondents’ perceptions about the remedies of the diseases and vast majority depended on the divine blessings. Almost equal majority of the respondents emphasized on the proper treatment as the remedies of the diseases.
How the diseases are cured
Pct of Pct of
Category label Count Responses Cases
Spontaneously 108 12.9 31.0
Through proper treatment 276 32.9 79.3
Through (both) proper treatment and God' 24 2.9 6.9
God’s wish 288 34.3 82.8
Others 144 17.1 41.4
------- ----- -----
Total responses 840 100.0 241.4
57. Among the interviewed respondents, it is of particular interest, 93.1% informed that their source of health information (whatever the qualities) is "imam/priest/religious personality", whereas, 34.5% described "government health workers" for it. Also of interest that NGO contributed only for 6.9% as the source of health information.
-While exploring the sources of health information, we found vast majorities of the respondents informed of the "imam/priest/religious personality", although the qualities of the information from this source always remain doubtful for known reasons. Far less number of respondents informed of the source as "government health workers", but most of the information from this source are reasonably counted as correct or modern.
Source of health information
Pct of Pct of
Category label Count Responses Cases
Government health workers 120 17.2 34.5
NGO health workers 24 3.4 6.9
Radio/TV/news paper/mass-media 24 3.4 6.9
School teacher 24 3.4 6.9
Imam/priest/religious personality 324 46.6 93.1
Social leaders/local elite/community lea 60 8.6 17.2
Others 84 12.1 24.1
Quack doctor/pharmacist/village doctors/ 36 5.2 10.3
------- ----- -----
Total responses 696 100.0 200.0
59. Among the interviewed respondents, about 41.4% described "private M.B.B.S. doctors" and about 34.5% informed of "Quack/non-M.B.B.S. private doctors" as the best treatment providers. However, only about 13.8% thought "Government hospital" as the best treatment providers.
-The perceived MBBS doctors as the best treatment providers when rendering treatment privately, however, they are not perceived to do so when they render treatment from Government hospitals! It is interesting to note that, the respondents didn’t fail to identify the most modern care givers, but again, the trouble is with their "private" status which is related with their high payments mostly.
| Best treatment provider according to the respondents |
|
| Frequency |
| Valid Percent |
|
| Government hospital | 48 |
| 13.79 |
|
| Private M.B.B.S. doctors | 144 |
| 41.38 |
|
| Quack/non-M.B.B.S. private doctors | 120 |
| 34.48 |
|
| Homeopath/Kabiraji/traditional healers | 36 |
| 10.34 |
|
| Total | 348 |
| 100.00 |
|
60. Among the interviewed respondents, about 96.6% expressed their dissatisfaction in treatment in government hospitals in general.
-This finding on the service seekers’ satisfactions in the treatments in Government hospitals invariably affects their health care behaviors, adversely in most cases, as they go to some cheaper outlets (homeopathy, kobiraji etc.).
| Satisfaction in treatment in the Government hospitals |
|
| Frequency |
| Valid Percent |
|
| Satisfied | 12 |
| 3.45 |
|
| Not satisfied | 336 |
| 96.55 |
|
| Total | 348 |
| 100.00 |
|
61. Among the interviewed respondents, 69% informed their cause of dissatisfaction as "behavior of the doctors/staffs in government hospitals is not good and less care". About 58.6% were dissatisfied because of unavailability of required medicines, whereas 62.1% showed their dissatisfaction due to absence of doctor in the outlets/hospital. However, only 3.4% respondents are satisfied in government hospitals putting reason of having best doctors there.
-Policy making levels should be aware of these finding as these affect the health care behaviors of the population.
Reasons for not satisfied in Govt. hospital
Pct of Pct of
Category label Code Count Responses Cases
(Dissatisfaction)Doctors available rarely 216 22.2 62.1
(Dissatisfaction)Behavior no good/no care 240 24.7 69.0
(Dissatisfaction)Medicines not available 204 21.0 58.6
(Dissatisfaction)Environment not good 108 11.1 31.0
(Dissatisfaction)Hospital not clean 96 9.9 27.6
Dissatisfaction) Beds not good 48 4.9 13.8
Others 24 2.5 6.9
(Satisfaction)They are the best doctors 12 1.2 3.4
Don't know 24 2.5 6.9
------- ----- -----
Total responses 972 100.0 279.3
62 Among the interviewed respondents, about 55.2% admitted that the disease could be healed through spiritual means. However, about 44.9% did not agree in the issue.
-Majority of the respondents still believe that the diseases can be healed through spiritual means!
| Whether diseases can be treated with spiritual means |
|
| Frequency |
| Valid Percent |
|
| Yes | 192 |
| 55.17 |
|
| No | 156 |
| 44.83 |
|
| Total | 348 |
| 100.00 |
|
63. Among the interviewed respondents, about 89.7% thought male’s permission was necessary for the treatment of female family members.
-Reflecting the governing male roles in the rural Bangladeshi community.
| Male's permission for the treatment of the females |
|
| Frequency |
| Valid Percent |
|
| Male's permission required to treat female pt. | 312 |
| 89.66 |
|
| Male's permission does not require | 36 |
| 10.34 |
|
| Total | 348 |
| 100.00 |
|
64. Among the interviewed respondents who supported the view of male’s permission for female’s treatment, about 38.5% respondents put the cause as "males are the head of the family", whereas about 23% put the cause as "Males are income earning ". However, about 7.7% did not know why they advocated for the male’s permission!
-These are the excuses for those overriding male roles in the community. Answer to these excuses should be made available for a successful health policy.
| Causes for seeking males’ permission for treatment of the females |
|
| Frequency |
| Valid Percent |
|
| Males are the head of the family/ | 120 |
| 38.46 |
|
| Males are income earning | 72 |
| 23.08 |
|
| Males re are more knowledgeable/educated | 60 |
| 19.23 |
|
| Male's are always decision makers | 36 |
| 11.54 |
|
| Don't know | 24 |
| 7.69 |
|
| Total | 312 |
| 100.00 |
|
| System | 36 |
|
|
|
|
| 348 |
|
|
|
65. Mean expense for the treatment of diarrhoea was notified as about Tk. 70 where minimum and maximum were Tk. 50 and Tk. 100 respectively.
-Gives us an idea of the specific treatment costs for once according to the respondents
| Average cost (in taka) in diarrhea treatment |
|
| Frequency |
| Valid Percent |
|
| 50 | 84 |
| 24.14 |
|
| 60 | 72 |
| 20.69 |
|
| 70 | 72 |
| 20.69 |
|
| 75 | 24 |
| 6.90 |
|
| 80 | 24 |
| 6.90 |
|
| 100 | 72 |
| 20.69 |
|
| Total | 348 |
| 100.00 |
|
66. Mean expense for the treatment of pneumonia/grave respiratory infection was notified as about Tk. 180 where minimum and maximum were Tk. 90 and Tk. 250 respectively.
| Average cost (in taka) the treatment of pneumonia |
|
| Frequency |
| Valid Percent |
|
| 90 | 24 |
| 6.90 |
|
| 100 | 24 |
| 6.90 |
|
| 150 | 120 |
| 34.48 |
|
| 200 | 96 |
| 27.59 |
|
| 250 | 84 |
| 24.14 |
|
| Total | 348 |
| 100.00 |
|
67. Mean expense for the treatment of Reproductive Tract Infection (RTI)/Sexually Transmitted Disease (STD) was notified as about Tk.266 where minimum and maximum were Tk. 100 and Tk. 400 respectively.
| Average cost (in taka) in RTI/STD treatment |
|
| Frequency |
| Valid Percent |
|
| 100 | 24 |
| 6.90 |
|
| 150 | 36 |
| 10.34 |
|
| 200 | 96 |
| 27.59 |
|
| 250 | 60 |
| 17.24 |
|
| 300 | 24 |
| 6.90 |
|
| 400 | 108 |
| 31.03 |
|
| Total | 348 |
| 100.00 |
|
68. Mean expense for the treatment of abortion was notified as about Tk. 591 where minimum and maximum were Tk. 150 and Tk. 1000 respectively.
| Average cost (in taka) in treatment of abortion |
|
| Frequency |
| Valid Percent |
|
| 150 | 24 |
| 6.90 |
|
| 400 | 60 |
| 17.24 |
|
| 500 | 12 |
| 3.45 |
|
| 600 | 132 |
| 37.93 |
|
| 700 | 60 |
| 17.24 |
|
| 750 | 36 |
| 10.34 |
|
| 1000 | 24 |
| 6.90 |
|
| Total | 348 |
| 100.00 |
|
69-An important finding for the management of Jaundice, policy makers should emphasize the respondents’ perceptions about etiology of Jaundice as the health care behaviors depend on that.
| Desired modern/scientific treatment of jaundice |
|
| Frequency |
| Valid Percent |
|
| Occasionally keen for modern treatment | 96 |
| 27.59 |
|
| Never keen for modern treatment | 252 |
| 72.41 |
|
| Total | 348 |
| 100.00 |
|
70. Among the interviewed respondents, 93.1% opted for "homeopath/Kabiraji/traditional healers" if got jaundiced! Again, the rest 6.9% disclosed their desired treatment centers/healers as "religious/spiritual healers" if become jaundiced!
-Vast majority of the respondents opted for Homeopathy if the disease is Jaundice; the rest is opted for the spiritual healings! It is linked with their perceptions of the etiologies of jaundice and thus the health care behaviors are developed.
| Desired outlet in the treatment of jaundice |
|
| Frequency |
| Valid Percent |
|
| Homeopath/Kabiraji/traditional healers | 324 |
| 93.10 |
|
| Religeous/spiritual healers | 24 |
| 6.90 |
|
| Total | 348 |
| 100.00 |
|
2. Rangpur Sadar Upazilla was accounted for the highest number of interviews (71.8%), Rajar Hat and Ulipur Upazilla, both within Kurigram District, were accounted for about 14.4% and 13.8% interviews respectively. For the same reason mentioned above, Sadar Upazilla of Rangpur District accounted for highest number of respondents and two Upzillas of Kurigram District were accounted for the rest of the sampled respondents.
3. Uttam Union of Rangpur Sadar Upazilla was accounted for the highest number of interviews (71.8%), Chhinai Union of Rajar Hat Upazilla and Pandul Union of Ulipur Upazilla, both within Kurigram District, were accounted for about 14.4% and 13.8% interviews respectively. Sampled Unions were accounted for mentioned sampling.
5. About 6.6 % respondents were from East Para of the Goalu village, where as other Paras of Goalu namely West Para, Khayan and "other" Paras accounted for 10.1%, 16.1% and 14.7% respondents respectively. Paras in the village Bahadur Singha accounted for 13.5% of the interviewed respondents. Mollah Para, Kamar Para and Char Joy kumar accounted for 10.9%, 6.9% and 7.2% respectively.Random/systematic random sampling techniques have been used (details in the sampling technique chapter).
7. Mean age of the respondents interviewed was 44.4 years. The highest aged respondent interviewed was/were of 62 years and lowest of 30 years. The ages of the respondents were between 30-62 years. These are the ages in which a respondent can be mentioned as of normal age of knowledge and capable of understand and disseminate any information normally.
8. Among the interviewed primary respondents 8.9% was Pundro-Khastrio/Rajbanshi/Kuch1. About 74.4% and 4.3% was Muslim and general mainstream Hindu, Bairagi/Nath-hath-yogi/Baisnab2 and the Khyan were accounted for 5.2% and 7.2% respectively. It is interesting that although the mentioned population claim that they belong to the religion of Hindu, the mainstream of the Hindus have been continually refuse to admit the claim. In the observation at the field, it was seen that most of these unconventional Hindus are the descendants of the ethnic aboriginals, mostly the mongoloids anthropologically i.e. mostly possibly from Garos. Moe or less, it is the same scenario in everywhere of the rural population of Bangladesh, where this scheduled Hindus constitute a considerable portion of the total Hindu population of the area. 
9. Among the interviewed primary respondents, 44.5% were illiterate and 55.5% respondents were claimed to be literate. Again about 32.2% respondents interviewed were literate to the extent of primary level. Only 5.7% respondents interviewed were educated up to the S.S.C. level and above. Reflecting the situation in rural Bangladesh as a whole in the context of education. Only 5.7% SSC level education leaves the rural Rajshahi areas extremely vulnerable to superstitions and obstructs positive changes in the contexts of any modern and scientific knowledge and practice among the population.
10. Among the interviewed primary respondents, about 34.5% accounted for number of family members as 4, whereas about 17.2% have 8 member families. About 24.2% have family members more than 6. Only about 3.5% have families with 3 members. Expresses the excessive population in the rural areas and the family size in the households which is important to any design for health delivery system in the study population.
9. Among the interviewed primary respondents, about 29.3% belonged to the agriculture as their occupation, whereas about 46.6% were the housewives. About 8.3% were different professional groups. As we saw in previous table analyses, more than half of the respondents (51.7%) were females and here it is seen that about 46.6% of the total respondents are housewives. So, some of the females respondents had been doing something other than their roles as housewives.
10. Among the interviewed primary respondents, about 65.5% respondents’ economical condition was assumed as "not good". Only about 10.3% were identified having "good" or well off economic conditions. (Dresses, household utensils and other assets were indicators for the assumption). As the interview process was totally participatory and community based, interviewers were deployed from the community and they applied their indigenous techniques as they usually use to describe the economical conditions in their community and no highly precision scaling system was used due to the nature of the interviews. They could do it most preciously as the researcher thought. Economic conditions were predicted by the interviewer on certain general findings/criteria. How they pass their lives, what they eat, what they wear and what they do for income earning. Also idea was taken by observing their household for built and other criteria. This is the general understanding of the economic condition expressed in their livelihoods, not a very technical analysis and in most cases, it fulfills the objective to understand population’s situation. No strict economic measurement scale from any institute has been used, rather assumptions have been made with the indigenous idea found in the locality among the population to tell some one having "good", "average" or "not good" economic condition and those are dependent on the livelihood indicators of the assessed families or households (this is common practice in the rural Bangladesh to describe anyone’s economic condition)
17. Among the interviewed respondents’ families, about 13.8% live in houses with good road communications and 41.4% with average road communication. About 44.9% has the household with bad road communications. Here only 13.8% respondents, who live at the side of the highways and other subways, stated they had good road communications. Other stated it as "average" or "bad". Road communication has a great role in the health seeking behavior as people have to go to the service centers through the roads. However, not only the road, also the transportations are required, and in most good roads, some types of transportations are present.
