Cultural Dimensions of

1
Cultural Dimensions of Health, Disease, and
Healing
India
Carrie, Katie, and Laura
2
Gender Inequality It Starts Young

• Boys vs. girls
• Under-5 morbidity
• Lag time in seeking care
• Expenditure per episode
• Responses to fever

3
Women's Autonomy

• Most women do not get to make decisions regarding
  their own health
• Influences
• Education
• Employment
• Age
• Marriage kinshippatterns

Rani Bonu, 2003
4
Home vs. Hospital

• A majority of women still choose to give birth at
  home
• Fears
• Unfamiliar environment
• Forced sterilization
• Baby switched for less desirable one

5
When do Women Choose To Seek Medical Care?

• Curative rather than preventative approach
• Number of symptoms and severity
• A normal part of life?
• What will others think?

6
Rural vs. Urban Health
75 of the health infrastructure and medical
personnel in India are concentrated in urban
areas.
Almost 75 of Indias one billion people live in
villages.
70 of rural families spend 60 of their annual
income on health. Among the most common causes
of poverty in India is individual healthcare
spending.
7
Healthcare Delivery in India

• Forms of healthcare
• Biomedical public and private
• Traditional/Alternative mostly private

8
Comparing Health Statistics
Comparing health statistics of rural and urban
areas tells a story of great inequality
9
Urban Health

• Significant shortcomings of urban public health
  services
• meager for those most in need
• lack of uniform organizational structure
• slums without any infrastructure support

10
Urban Stress

• Urban stress is predictive of health problems
• high blood pressure
• health habits of chewing tobacco and alcohol use
• psychosocial characteristics, such as hostility

11
Rural Health Structure

• Sub-centers - Auxiliary Nurse Managers (ANM).
• Serve 25,000 to 48,000 people.
• Must increase by 16 adequately serve the
  population.

12
Scary Rural Health Provider Statistics

• 80 of general practitioners that practice
  allopathic care are not properly trained.
• 73 use cost as their first point of reference
  when prescribing medicine.
• 75 were aware of the PHC in their area but did
  not have information on who the health workers
  there were.
• 13.9 of private doctors have no formal
  qualifications
• 36 do not have a college degree in any subject
• A majority of non-medical staff also saw patients

13
Constraints on Rural Health Care

• Demand Side
• Illiteracy
• Malnutrition
• lack of infrastructure in accessing facilities
• Provider Side
• understaffed Only 38 of PHCs have the
  necessary manpower.
• under-funded Only 31 have critical supplies.
• inaccessible locations
• Combined result Severe inefficiency such that
  many Indians avoid using the existing public
  health facilities altogether.

14
Public vs. Private Health in Rural India

• Even though it is more affordable, poor and rural
  populations will pay more money to use private
  health services and traditional healers, rather
  than go to public health centers.
• Indians in rural settings choose to go to private
  doctors almost twice as much as public
  facilities.
• The rich visit public facilities more often than
  the poor, though no one uses the public
  facilities much.

15
Health Issues by Territory

• The health status of a large part of the Hindi
  speaking areas of north India, as well as the
  states of Orissa and Assam, remains adamantly
  vulnerable.
• The flood along the Bay of Bengal suffer from the
  endemic presence of vector-borne diseases and
  frequent damage to infrastructure.
• Cancerous Correlations
• of the mouth and tongue are particularly frequent
  in both genders in the southern states.
• of nasopharynx cancer were found in the
  northeastern states (Nagaland, Manipur).
• of cervical and penile cancer, stomach and lung
  cancer (in both genders) in many districts of
  Mizoram State.
• of high risk for gallbladder cancer seems larger
  than suspected previously, involving a wide band
  of northern India.
• of high incidence of thyroid cancer in females in
  a belt of southwest coastal districts

16
Impact of Globalization on Rural Health
Television

• One does not have to be literate or educated to
  watch television. Television leads to
• Change in cooking habits
• Change in openness to positive outlook for
  implementing new health ideas