Kaspar Wyss: Utilisation des services de santé en milieu urbain à N’Djaména (Tchad): Etude des déterminants et de leurs interactions

PhD-thesis, Faculty of Science, 1994

The study analyses the utilization of health services in the urban setting of N’Djamena. With a transdisciplinary approach (geographical, epidemiological and socio-anthropological), it looks especially at health seeking behavior and tries to understand the influencing factors and their interactions. Findings show that self-treatment and the use of traditional healers and public health services are common. The author further identifies four categories of elements that influence the choice of care: elements related to the person and his environment (cultural values, beliefs, knowledge, opinion of others, household structure, socioeconomic level, age, gender level of education); elements related to the disease (duration and severity); elements related to space (spatial distribution of the services, distance to the services, roads, means of transport); elements related to health services (knowledge of the service and the staff, proximity, quality, equipment, hygiene, opening hours, waiting time). Finally suggestions are made in order to improve access to health services.