Sociocultural differentiation in health behaviour was studied among 500 mothers randomly chosen in the suburban area of Dakar, Senegal. Variables were age, marital status, educational level, socioeconomic conditions, urban experience, town integration, village attachment, social insurance, ethnic group and disease categories. Access to health care was considered for the last illness of the mother and her youngest child under five. Town integration and disease category (and social insurance for children) were the only variables correlated with the number of consultations. Socioeconomic level and social insurance (and educational level for mothers) were associated with preference for private rather than public health systems.
PIP: 500 women from the Dakar, Senegal suburb of Pikine were surveyed on the type of health consultation they used for their own last illness or that of their youngest child under 5. The subjects were selected by 2-stage cluster sampling, from a map based on a recent aerial photo. The health care system in the town of 600,000 consists of 26 health centers, a number of dispensaries and 3 hospitals, 8 private clinics and 6 private pharmacies, and numerous street and market vendors and traditional practitioners. For the women's last illness, 21.9% made no consultation, 9.8% consulted a private clinic, and 68.3% consulted a public facility. For their children, 23.3% made no consultation, 3.5% consulted privately, and 73.2% consulted a public clinic. Average costs were $0.50 in public clinics, $10-15 in private clinics. 61.8% received prescriptions. Prescription costs ranged from $10 in dispensaries to $40 in private clinics. Town integration and disease categories were correlated with utilization of services; insurance was also correlated with pediatric consultations. Educational level was correlated with mothers and socioeconomic level for children. After multiple regression analysis, insurance and educational level persisted for mothers, and insurance only for children.