Why do men with urethritis in Cameroon prefer to seek care in the informal health sector?

Abstract

Objective: To study the impact of cost of treatment for sexually transmitted diseases (STDs) on the preference of men with urethritis to seek care in the informal sector. Subjects and methods: A random sample of young men from the general population of Yaounde and Douala, Cameroon, and of employees of a Yaounde factory underwent a structured interview on the occurrence of STD-related complaints and health seeking behaviour. Men who consulted in the formal sector were compared with men consulting in the informal sector, with regards to cost of medication and level of education. Results: Sixteen percent of men in the general population and 20% of factory employees reported a history of urethritis in the 12 months preceding the interview. Of the men in the general population 53% had sought care in the formal sector; among the factory employees this proportion was 56%. Men who did not consult in the formal sector spent significantly less on drugs than men who did consult in the formal sector: median cost $14 4 versus $24'0 (p = 002) for drugs purchased in pharmacies; median cost $8 versus $32 for drugs purchased in small stores or from acquaintances. Preference for formal health services was associated with higher educational attainment. Conclusion: In large towns in Cameroon the utilisation of formal health services for STD related complaints is low and the high cost of treatment in the formal sector may play an important role in the choice of care option.

Approaches to the control of sexually transmitted infections in developing countries: old problems and modern challenges

“…29 Promotion of appropriate treatment seeking behaviour and the role of the private sector Surveys of health seeking behaviour in developing countries indicate that a substantial proportion of people with symptomatic STIs seek treatment in the informal or private sector, from traditional healers, unqualified practitioners, street drug vendors, and from pharmacists and private practitioners, and they will only attend formal public health services after alternative treatments have failed. 30 Self medication is also popular in many settings. [30][31][32] Patients seek care in the private sector for many reasons, including their greater accessibility and convenience, and the more confidential, less judgmental, and less stigmatising nature of the services.…”

“…30 Self medication is also popular in many settings. [30][31][32] Patients seek care in the private sector for many reasons, including their greater accessibility and convenience, and the more confidential, less judgmental, and less stigmatising nature of the services.…”

Foundations for effective strategies to control sexually transmitted infections: Voices from rural Kenya

“…Research in Kenya (M oses et al, 1992), as well as in Cameroon (Crabbe et al, 1996), showed the high cost of treatment was a deterrent to the use of the public clinics. In studies from Zambia (Sajiwandani et al, 1987) and Swaziland (Green, 1992), shame and embarrassment inhibited persons from seeking care, particularly at public clinics.…”

Management of sexually transmitted diseases in urban pharmacies in The Gambia

“…Other consequences mentioned included`PID' (8),`damage to the fallopian tubes' (7),`ectopic pregnancy' (6), and`affecting newborns' (6). The main sources of information on the treatment of STD were professional training (11), in-service training (4) and DoSH guidelines (3).…”

“…Surveys of health-seeking behaviour in developing countries indicate that a substantial proportion of people with symptomatic STDs seek treatment in the informal or private sector from traditional healers, unquali® ed practitioners, street drug vendors, and from pharmacists and private practitioners 3± 7 , and will only attend formal public health services after alternative treatments have failed 8 . There are, however, indications that the management of STD patients in the informal or private sector is less than optimal, as allopathic practitioners may not use adequate drugs or suitable drug regimens, or may not provide proper education and counselling 7,9± 11 , whilst traditional healers and herbalists may use remedies with no proven antimicrobial ef® cacy 6 .…”