Determinants of the Use of Health Care and Therapeutic Routes of Populations in Rural Senegalese Areas, 2016

In Senegal, access to health care for rural populations and therapeutic choices remain problematic. These problems may be synonymous with insufficient financial resources, long waits, ineffective treatments, or drug shortage in health structures, leading patients to perform various therapeutic behaviours. The aim of this present study was to identify the therapeutic routes of the patients and the determinants of the different uses of health care in the populations of Ferlo. This descriptive and analytical study was carried out as part of the medical consultation days of the 2016 summer at the university in Widou Thiengoly. All patients who met the selection criteria were enrolled. In total, the 150 participants were mainly animal breeders (63.3%) and housewives (26%), also, most were women (90.7%). The analysis of the therapeutic routes showed that the health post was used as first-line and second-line respectively in 85.3% and 59.3% of the study populations. Traditional medicine and self-medication would be used in the third intention. Therapeutic choices were independent of age (p = 0.94), marital status (p = 0.84) and occupation (p = 0.58). On the other hand, social dimensions, such as tradition, appreciation of efficiency, distance, cost, and gender, also determine the use of health care. Women used health post more frequently than men (p = 0.03) (OR: 3.89, CI95% [1.16 - 12.98]) of the order 3.89. The main reasons for self-medication practice were the treatment of headache or fever (46%) and that of fatigue (26%). The prices were more expensive for health facilities (70.9%) than for traditional healers (70% “not expensive at all”) where the waiting time was considered “not long at all” (70%).