Outpatient Health Service Utilization in Pastoralist Communities of South Omo Zone, Southern Ethiopia

Abstract

Background: Almost all pastoralist communities in Sub-Saharan Africa are living in arid and semi-arid areas and are mobile to search water, grass and suitable place for themselves as well as for their livestock. Their mobility is a strategy to manage efficiently the uncertainty in a fragile environment where settled life is risky. Studies show that mobility renders the utilization of health and other social services rather difficult. Outpatient service utilization pattern in pastoralist communities in Ethiopia has not been studied. Available data are very few and mostly institution based. Methods:A cross-sectional study was conducted on 771 people, from February to March 2012, in three pastoralist woredas (districts) of the South Omo Zone, which is located in the south western part of Ethiopia. The study employed both quantitative and qualitative data collection methods. The quantitative data was collected by the use of a pre-tested questionnaire by interviewers trained for this purpose. Focus group discussions were carried out for collecting the qualitative data. Systematic sampling technique was used for household selection. Data entry, editing and analysis were done using SPSS for window version 16.0 statistical programs. Ethical clearance was obtained from Jimma University Collage of Public Health and Medical Science Ethical Review Committee.Results: Out of the 771 study participants 21.5% were female and 78.5% were male. 86.9% were illiterate and 13.1% had elementary education. 94.2% were followers of traditional and cultural beliefs and 5.8% were protestant. The mean age was 35 years. A total of 536(69.5%) individuals (414 males and 122 females) reported to have at least one episode of illness within the one year recall period. With regard to response to illness episodes, 242(45.1%) reported that they were self-treated, 217(40.5%) went to traditional healers, and only 77(10%) used modern health facilities. The main factors affecting outpatient utilization were distance and level of household literacy. Conclusion:The findings show very low utilization of services among mobile pastoralists in South Omo Zone, Southwest of Ethiopia. The main factors affecting outpatient utilization was distance and level of household literacy. Reducing distance of health facilities and expansion of primary education are recommended.

“It is difficult for us to treat their pain”. Health professionals’ perceptions of Somali pastoralists in the context of pain management: a conceptual model

“…Only 10% of pastoralists in Southern Ethiopia make use of modern healthcare facilities in case of illness. The majority seeks aid from traditional healers or prefers self-treatment ( Kawza, Dejene, and Hailemariam 2018 ). Carruth (2014) found in her study that the pastoralists’ perception of illness can be described as pluralistic and ambiguous.…”

“I could not bear it”: Perceptions of chronic pain among Somali pastoralists in Ethiopia. A qualitative study

“…For pastoralists as a socially and geographically marginalized population, access to biomedical health services is challenging [ 18 , 20 ]. Studies of the proportion of pastoralists in Ethiopia who use health services to treat their illnesses vary widely according to region, distance to health facilities and other factors such as mobility [ 21 – 23 ]. A study in rural Western Ethiopia found that 36.7% of households reporting illness episodes were self-medicating with modern drugs, most commonly antibiotics and analgesics.…”

“…Common reasons among pastoralists for not visiting health facilities are the far distance of health institutions from the place of residence or cultural beliefs that health services lack efficacy for certain health problems [ 21 ]. In addition, the necessary resources especially for treating pain, such as pain medication, are often not available in health care facilities [ 26 ].…”

“…Pastoralists commonly also seek aid from traditional healers or prefer self-treatment when experiencing illness symptoms [ 22 , 27 ]. In such contexts, pain can lack prioritization as a serious health problem–on the part of pastoralists themselves and also on the part of health professionals [ 11 , 21 , 26 ]. However, Carruth argued that seeking biomedical aid is ever-changing in this population as pastoralists alter their views about healthcare and adapt to new environments [ 19 ].…”