DETERMINANTS OF THERAPEUTIC ROUTES FOR MALARIA PATIENTS IN IVORY COAST
Abstract
Malaria patients in Ivory Coast pursue a wide variety of treatment routes, depending upon how they understand the aetiology of their illness, their association of illness with supernatural causes, their ability to afford standard consultation fees, their access to conventional health care facilities, and their confidence in traditional African therapies. This research took place in the context of the government ' s policy of providing free management of ' simple malaria ' for all. Working with four conventional doctors and four traditional African medical practitioners, treatment choices of 161 malaria patients were analysed at Kennedy-Clouétcha, a busy urban health care centre in Abidjan. Almost half (77) of the patients in the study cited mosquito bites, general poor health, and stagnant water sources as the causes of their malaria. A greater number of patients (84) indicated fatigue, sun exposure, mysticism, and diet as the cause. The scope of therapies sought by these patients covered conventional biomedical treatment, traditional African medicine, and prayer. When patients were not cured through methods of their first resort, they pursued second options for care. Despite the availability of free care in centrally located public health systems, the therapeutic trajectory of many patients diverted away from conventional treatment. The data suggests that a patient ' s orientation away from the conventional biomedical model may be best explained by confusions surrounding the diagnostic label ' simple malaria ' .
Keywords: malaria, patient choices, therapeutic routes, free treatment, traditional African medicine
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