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      Health care seeking and financial behaviours of the elderly during wartime in Goma, Democratic Republic of Congo

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          ABSTRACT

          Background

          Health and social services utilisation is seen to be more closely related to age than to other socio-demographic characteristics. Many health problems are known to increase with age and this demographic trend may lead to an increase in the absolute number of health conditions in this population. However, questions are still emerging as to how the elderly seek care in response to their needs in the context of a war-torn region.

          Objectives

          The aim of this study was to determine the behaviour of the elderly in seeking care during a time of conflict.

          Method

          A descriptive cross-sectional study was carried out in the health district Goma, in the Democratic Republic of the Congo (DRC), using a multistage sampling of 500 senior citizens. Eight trained field-workers were deployed in the field where they administered a structured questionnaire.

          Results

          The public health sector was well known and preferred by 186 participants (37.2%), but only used by 16 (3.2%) participants. Financial support received by the elderly came from their own relatives and fellow believers in 33.5% and 20.2% of cases, respectively. Almost 71% of monetary support is the result of begging and unknown sources – there is no government involvement whatsoever. Much of the external support that the elderly receive involves support in the form of food. Disease expenses remain a main concern of the elderly themselves.

          Conclusion

          Government support for the elderly in the DRC is non-existent. There is an overuse of private sector and traditional medicine, despite the preference indicated for the public health sector. As a recommendation, a general increase in income-related activities could contribute to alleviating the health state of the elderly in a war situation. Further studies might explore in future the contribution of those results on the health of elders.

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          Most cited references 22

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          Constructions of masculinity and their influence on men's well-being: a theory of gender and health.

           W H Courtenay (2000)
          Men in the United States suffer more severe chronic conditions, have higher death rates for all 15 leading causes of death, and die nearly 7 yr younger than women. Health-related beliefs and behaviours are important contributors to these differences. Men in the United States are more likely than women to adopt beliefs and behaviours that increase their risks, and are less likely to engage in behaviours that are linked with health and longevity. In an attempt to explain these differences, this paper proposes a relational theory of men's health from a social constructionist and feminist perspective. It suggests that health-related beliefs and behaviours, like other social practices that women and men engage in, are a means for demonstrating femininities and masculinities. In examining constructions of masculinity and health within a relational context, this theory proposes that health behaviours are used in daily interactions in the social structuring of gender and power. It further proposes that the social practices that undermine men's health are often signifiers of masculinity and instruments that men use in the negotiation of social power and status. This paper explores how factors such as ethnicity, economic status, educational level, sexual orientation and social context influence the kind of masculinity that men construct and contribute to differential health risks among men in the United States. It also examines how masculinity and health are constructed in relation to femininities and to institutional structures, such as the health care system. Finally, it explores how social and institutional structures help to sustain and reproduce men's health risks and the social construction of men as the stronger sex.
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            Causes and consequences of comorbidity: a review.

            A literature search was carried out to identify and summarize the existing information on causes and consequences of comorbidity of chronic somatic diseases. A selection of 82 articles met our inclusion criteria. Very little work has been done on the causes of comorbidity. On the other hand, much work has been done on consequences of comorbidity, although comorbidity is seldom the main subject of study. We found comorbidity in general to be associated with mortality, quality of life, and health care. The consequences of specific disease combinations, however, depended on many factors. We recommend more etiological studies on shared risk factors, especially for those comorbidities that occur at a higher rate than expected. New insights in this field can lead to better prevention strategies. Health care workers need to take comorbid diseases into account in monitoring and treating patients. Future studies on consequences of comorbidity should investigate specific disease combinations.
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              Behavioral Factors Associated with Disease, Injury, and Death among Men: Evidence and Implications for Prevention

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                Author and article information

                Journal
                Afr J Prim Health Care Fam Med
                Afr J Prim Health Care Fam Med
                PHCFM
                African Journal of Primary Health Care & Family Medicine
                AOSIS OpenJournals
                2071-2928
                2071-2936
                14 June 2010
                2010
                : 2
                : 1
                Affiliations
                [1 ]Department of Family Medicine, University of Goma, DRC
                [2 ]Chercheur Indépendant Programme Elargi des Vaccinations, DRC
                [3 ]Department of Community Health School, Public Health College of Medicine, Malawi
                [4 ]Chercheur Indépendant Programme Ecole Sans Enseignant Bukavu, DRC
                [5 ]Centre Interdisciplinaire de Bioéthique pour L'Afrique Francophone, DRC
                Author notes
                Correspondence to: Prosper Lutala, email: jolutprosper@ 123456yahoo.fr , Postal address: Department of Family Medicine, University of Goma, B.P. 204, Goma, Nord-Kivu, DRC.

                How to cite this article: Lutala MP, Kwalya TM, Kasagila EK, Watongoka LH, Mupenda BW. Health care seeking and financial behaviours of the elderly during wartime in Goma, Democratic Republic of Congo. Afr J Prm Health Care Fam Med. 2010;2(1), Art. #108, 5 pages. DOI: 10.4102/phcfm.v2i1.108

                This article is available at: http://www.phcfm.org

                Article
                PHCFM-2-108
                10.4102/phcfm.v2i1.108
                4565911
                © 2010. The Authors

                AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License.

                Categories
                Original Research

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