[afro-nets] Health Care Behavior of the Rural People (2)

[Dr. Shamim ul Moula <shamimul.moula@gmail.com>]

"Psychosocial Factors Related to Health Care Behavior of the Ru-
ral People Under Rajshahi Division"
----------------------------------------------------------------

I have recently concluded the Ph.D. thesis in the above men-
tioned topic. Here I just mention the methodology and the asso-
ciated survey findings for my comrades in brief who may find
anything helpful among these. I got many request to send infor-
mation in the topic. It should be recalled that the study was
conducted in a part of Bangladesh. Mostly rural people's health
care behaviours (depending mostly upon their traditional beliefs
and the socio-economic and cultural values and capacities) have
been surfaced in the response of the skilful use of appropriate
data collection instruments. When I started my Ph.D. study, I
unfortunately perceived that sufficient secondary information
was available in the topic, and I got very little. Some very
kind colleagues from overseas advised me and sent me materials
whatever they got. It is why I desire to put the information in
the network, so others in need may get any help if they find
within it.

Sincerely,

Dr. Shamim ul Moula
Bangladesh
mailto:shamimul.moula@gmail.com


--
Methodology and survey findings

?     Study design

a) The researcher decided a study directed for generalized ex-
ploration, tracking and documentation of the psychosocial fac-
tors. As the behavioral studies are rare and the health behav-
ioral studies are the rarest in Bangladesh and in the region, it
is assumed that the best would be to explore, track and document
the generalized contexts first in this study. In future, inter-
ested quarters can initiate more specific studies in the sub-
contexts.

b) Reviewing literatures and secondary data in the contexts
whatever are available for the behavioural studies giving empha-
ses to health behavioural studies to find the knowledge gaps and
to focus those in this study.

c) In-depth interview of the respondents with carefully designed
questionnaire is capable of yielding desirable information in
the contexts.

d) Sample number: About 348 interviews from 348 rural respon-
dents seemed to be statistically sound and valid to represent
the rural Rajshahi Division. Among them, 248 respondents were
sampled from Rangpur District for representation of Rajshahi Di-
vision typical rural population and another 100 from Kurigram to
fill the ethnic gap if there's any.

?     Sampling technique

Sampling technique: Stratified random sampling, systematic ran-
dom sampling, and purposive sampling technique have been used to
select the respondents.

?     Study area

The study area was the Village of Golau in Mouza Goalu of Union
of Uttam in Rangpur Sadar Thana of the district of Rangpur and
villages of two Thanas of Kurigram District.

?     Goalu and Bahadur Sinha of Rangpur Sadar Thana of Rangpur
District are the typical villages of rural Rajshahi Division of
Bangladesh and inhabited by typical rural population within 8
kilometers of Rangpur town.

?     Number of villages of Chhinai and Pandul Unions under Ra-
jarhat and Ulipur Thanas of the District of Kurigram under Ra-
jshahi Division are chosen as samples to achieve responses for
minimize the ethnic gaps as those areas are widely inhabited by
the descendents of the Koch, Khyan and Yogis with their tradi-
tional beliefs and practices. They are at about 10 and 14 km.
distance from Kurigram District Headquarter respectively.

?     Data collection technique (quantities/qualitative)

A) Surveys have been conducted with the sampled respondents de-
termined through sampling techniques as mentioned in households
among family members (adult females and males depending upon the
opportunities)

B) In order to collect data to meet the study objectives and
queries, respondents were interviewed in-depth with a semi-
structured questionnaire.

C) Direct observation by the data collection/investigation team
whenever/wherever required.

  ?    Data collection instruments

i)    Semi-structured in-depth questionnaire (with 394 fields
and of both single and multiple responses) (finalized after pre-
testing in the field on the draft for necessary modifications
for convenience to elicit responses precisely).

ii)   Direct observation (whenever and wherever possible)

FINDINGS OF THE SURVEY

For the planned in-depth interview of the respondents i.e. the
rural population for qualitative data, data collection instru-
ment had been designed carefully as a qualitative questionnaire
having mostly unstructured questions with general outlines of
the topics. Clarifications were obtained by skilful follow-up
questions. From the very beginning, the respondents were kept
carefully unprovoked and no leading questions were put. Biasness
was carefully avoided. They were totally free to discuss their
topics in their own language and deployment of local females
made the interactions even easier. Interviewers just tried them
to keep in the topic tracts and not to deviate much except when
necessary.

A. SOCIO-ECONOMIC AND DEMOGRAPHIC INFORMATION

1. About 71.8% respondents were interviewed from Rangpur Dis-
trict and the rest 28.2% were from Kurigram District.

2. Rangpur Sadar Thana was accounted for the highest number of
interviews (71.8%), Rajar Hat and Ulipur Thana, both within Ku-
rigram District, were accounted for about 14.4% and 13.8% inter-
views respectively.

3. Uttam Union of Rangpur Sadar Thana was accounted for the
highest number of interviews (71.8%), Chhinai Union of Rajar Hat
Thana and Pandul Union of Ulipur Upazilla, both within Kurigram
District, was accounted for about 14.4% and 13.8% interviews re-
spectively.

4. Among the respondents for in-depth interview, 37.4% live in
Goalu, 34.5% is from the village of Bahadur Singha, whereas,
Purbo-Debottor and Joykumar both accounted for 7.2% and Apuar
Khata and Paschim Apuar Khata accounted for 6.9% respondents.

5. About 6.6 % respondents were from East Para of the Goalu vil-
lage, where as other Paras of Goalu namely West Para, Khayan and
"other" Paras accounted for 10.1%, 16.1% and 14.7% respondents
respectively. Paras in the village Bahadur Singha accounted for
13.5% of the interviewed respondents. Mollah Para, Kamar Para
and Char Joy kumar accounted for 10.9%, 6.9% and 7.2% respec-
tively.

6. About 51.7% of the interviewed respondents were female.

7. Mean age of the respondents interviewed was 44.4 years. The
highest aged respondent interviewed was/were of 62 years and
lowest of 30 years.

8. Among the interviewed primary respondents 8.9% was Pundro-
Khastrio/Rajbanshi/Kuch1. About 74.4% and 4.3% was Muslim and
general mainstream Hindu, Bairagi/Nath-hath-yogi/Baisnab2 and
the Khyan were accounted for 5.2% and 7.2% respectively. It is
interesting that although the mentioned population claim that
they belong to the religion of Hindu, the mainstream of the Hin-
dus have been continually refuse to admit the claim. In the ob-
servation at the field, it was seen that most of these unconven-
tional Hindus are the descendants of the ethnic aboriginals,
mostly the mongoloids anthropologically i.e. mostly possibly
from Garos. Moe or less, it is the same scenario in everywhere
of the rural population of Bangladesh, where this scheduled Hin-
dus constitute a considerable portion of the total Hindu popula-
tion of the area.

9. Among the interviewed primary respondents, 44.5% were illit-
erate and 55.5% respondents were claimed to be literate. Again
about 32.2% respondents interviewed were literate to the extent
of primary level. Only 5.7% respondents interviewed were edu-
cated up to the S.S.C. level and above.

10. Among the interviewed primary respondents, 2.3% were un-
veiled having physical disabilities of varying degree ranging
from bedridden to the conditions related to chronic arthritis
compromising there physical fitness for routine daily works.

11. Among the interviewed primary respondents, about 34.5% ac-
counted for number of family members as 4, whereas about 17.2%
have 8 member families. About 24.2% have family members more
than 6. Only about 3.5% have families with 3 members.

12. Among the interviewed primary respondents, about 29.3% be-
longed to the agriculture as their occupation, whereas about
46.6% were the housewives. About 8.3% were different profes-
sional groups.

13. Among the interviewed primary respondents, about 65.5% re-
spondents' economical condition was assumed as "not good". Only
about 10.3% were identified having "good" or well off economic
conditions. (Dresses, household utensils and other assets were
indicators for the assumption)

14. Among the interviewed primary respondents, about 58.6% have
the income source related to agriculture. About 20.7% have the
income source related to the business i.e. small business like
grocery shop or village market shops, tea-stalls etc. Different
types of low-graded services contributed for about 13.8% of the
income source, whereas different professional activities consti-
tuted the rest 6.9% of the responses regarding the income
sources.

15. As per the statement of the interviewed primary respondents,
their mean family income earning per month had been seen as
about Tk. 2345 of which Tk. 4000.00 is the highest and Tk.
800/month is the lowest income earning per family.

16. .Among the interviewed primary respondents, about 58.6% are
income earning, whereas about 41.4% are not income earning mem-
bers of their families (mostly the housewives and the
old/disabled persons).

17. Among the interviewed primary respondents income earners,
the mean income earring were about Tk. 1306, whereas, Tk.
3000.00 and Tk. 500.00 were the maximum and the minimum income
earrings respectively. 18. Among the interviewed primary respon-
dents' families, about 86.2% lived in the houses owned by them;
however about 13.8% were sheltered in the houses of their rela-
tives or known families. Absence of rented house as any inter-
viewed family's living place reflects the normal rural phenome-
non of the area.

19. Among the interviewed primary respondents' families, about
75.9% were living in thatched houses (house built by bamboo,
wood and straw, very rarely with tin roof. Rest about 24.1%
lived in semi-pucca houses built of which ranged from mere brick
platform to the houses with brick structure with tin in the
roofs.

20. Among the interviewed respondents' families, about 13.8%
live in houses with good road communications and 41.4% with av-
erage road communication. About 44.9% has the household with bad
road communications.

21. Among the interviewed respondents' families, about 55.7%
have no tube wells or electricity in their houses, whereas,
39.4% and 20.4% have tube wells and electricity respectively in
their houses.

22. Among the interviewed respondents' families, 74.7% and 69%
owned watches and radios respectively, whereas, 52.9% owned bi-
cycles (proportion is seen pretty higher, possibly for transport
of the adult males to Rangpur or other places wherever necessary
in the mud road). About 4.6% had televisions (mostly in their
grocery shops), whereas, 12.4% had nothing such in there houses.
About 10.3% have rickshaw or bull-carts, mostly for giving rent
for income earning.

23. Of the interviewed respondent females, 36.1% husbands were
illiterate, whereas, 40.7% were literate to the extent of pri-
mary levels. Only 2.8% husbands were educated up to degree
(Bachelor) level.

24. Of the interviewed respondent males, 54.8% wives were illit-
erate, whereas, 32.1% were literate to the extent of primary
levels. Only 3.6% wives were educated up to S.S.C. level. About
1.8% has no wives then, either died or separated.


B. KNOWLEDGE, ATTITUDE AND PRACTICE

25. Among the interviewed respondents, 48.3% had not any knowl-
edge of any UHC/MCWC nearby, whereas, 51.7% had that knowledge.
Lack of the knowledge in the issue reflects possibly their lack
of interest in the government service delivery outlets.

26. Among the interviewed respondents, none informed of their
regular contact with the government hospitals for treatment,
whereas 27.6% stated that they never go GoB outlets for treat-
ment. However, 72.4% go there for treatment only occasionally.

27. Among the interviewed respondents, only 6.9% expressed their
satisfaction in treatment in Government service outlets or hos-
pitals any where. A vast majority of 89.7% expressed their dis-
satisfaction for treatment in GoB hospitals, whereas, a much
lower proportion (3.5%) stated differently in the issue i.e. too
much rush causes trouble for treatment in GoB hospitals, without
medicines what the doctors would do?

28. Among the interviewed respondents, 82.8% informed "no medi-
cines available" as their reason for not going to GoB hospitals
(anyone) for treatment, whereas, 65.5%, 44.8% and 41.4% informed
of their reasons as the absence of doctors, bad road communica-
tion for going for treatment and "bad" behavior of the doctors
respectively.

29. Among the interviewed respondents, all (100%) informed of
quack/non-MBBS private doctors as the service outlet for the
treatment of their family members, whereas, 82.8% informed both
of religious/spiritual healers and Homeopath/ Kabiraji/ tradi-
tional healers for the same indicating the strong affinity of
the rural population of Bangladesh for medieval treatment proce-
dures for different reasons. Curiously NGO outlets had been de-
scribed for the same by only 6.9% of the respondents.

30. Among the interviewed respondents, all (100%) respondents
described "low cost treatment" as the reason to select treatment
outlets for the family members. Again 58.6% and 51.7% respon-
dents described the reasons as "treatment facilities always
available" and "nearer to the patient's house" respectively.
About 44.8% respondents accounted for "treat with care and lis-
ten/counsel well" as the reason for the same.

31. Among the interviewed respondents, only 17.3% expressed
their satisfaction in treatment wherever they get that. Curi-
ously interesting is the finding is that, a vast majority of
82.8% remained "unsatisfied" with treatment, even in their out-
lets/hospitals of choice for the treatment of their family mem-
bers!

32. Among the interviewed respondents, 75.9% disclosed their
reason for dissatisfaction as "Needs time to cure/can't diagnose
properly", whereas, 51.7% for "high fee", 41.4% stated their
reasons of dissatisfactions for both "requires repeated visit"
and "frequently prescribing injection/I.V. saline". About 31%
described their reason for dissatisfaction as "bad behavior of
the doctors and staffs of the hospitals". Among the reasons for
satisfaction, "see the patients with care" and "good treatment"
accounted for 17.2% and 6.9% respondents respectively.

33. Among the interviewed respondents, 93.1% believed the etiol-
ogy of disease as "from the anger of Allah/God", whereas, 65.5%
thought the etiology as "from infection by germs". About 41.4%
informed of "other" reasons as the etiology i.e. "dissatisfac-
tion of gods", "dissatisfactions of the nymph" etc.

34. Among the interviewed respondents, 72.4% informed of provid-
ing first aids in home for patients, whereas, 27.6% informed of
not providing first-aid in home.

35. Among the interviewed respondents, 65.5% informed that the
female chiefs of the corresponding families had supervised the
family first aid. Only 17.2% informed that the male chiefs did
it. Another 17.2% informed of the supervision by others like
other family members etc.

36. Among the interviewed respondents, 93.1% expressed their be-
liefs in traditional/folk medicine, whereas, the rest 6.9% in-
formed of their no belief in traditional/folk medicine.

37. Among the interviewed respondents, all (100%) respondents
stated "green coconut water/ liquid /ORS/ laban-gur preparation
(salt-molasses solution)" as the traditional/folk or indigenous
treatment of diarrhoea, whereas, 93.1% respondents informed of
the "holly water/talisman/exorcism" as the as the tradi-
tional/folk or indigenous treatment of diarrhoea. "Herbal ex-
tracts/herbs" accounted for 31%, whereas, unfortunately another
51.7% and 24.1% of the respondents opted for "heals spontane-
ously" and "closure of feeding" respectively indicating exis-
tence of potential grave public health risk in the issue still
prevailing in the rural Bangladesh regardless the highly adver-
tised optimistic views of government and many NGOs.

38. Among the interviewed respondents, 96.6% described "massag-
ing warm oil/garlic-warm oil in chest" as the traditional/folk
treatment for the respiratory infections including pneumonitis
in the rural Bangladesh. About 72.4% opted for "ingesting
tulsi/other herb extracts", whereas, 48.3% and 31% had opted for
"drinking honey with or without hot water" and "eating onion-
rice" respectively. About 10.3% opted for "spontaneous healing"
signifying potential public risk in the disease still prevailing
in rural Bangladesh.

39. Among the interviewed respondents, it was curiously unveiled
that 62.1% stated the traditional/folk treatment or remedy of
RTI/STD as "coitus with virgin/fresh women"! Again 55.2% de-
scribed "ingesting herbal extracts" as the traditional/folk
treatment of RTI/STD, whereas another 69% had opted for "ingest-
ing country elixirs (Saribadi salsa etc.). Only 34.5% and 20.7%
had been accounted for the more scientific approaches like "ir-
rigating/washing genital organs with saline" and "drinking ex-
cess of water" respectively. However, 34.5% opted for poten-
tially risky "heals spontaneously".

40. Among the interviewed respondents, 89.7% opted for "holy wa-
ter or talisman" as the traditional/folk remedy of abortion,
whereas 79.3% depends on the "exorcism and different religious
rites" as the traditional remedy for the same. Again 37.9%
stated on behalf of "ingesting herbal extracts/Kabiraji /salsa"
as the remedy. However, 48.3% opted for alarming "heals sponta-
neously"! 38. Among the interviewed respondents, 72.4% opted for
"eating rice with herbal preparation' and also another 69% de-
scribed "ingesting herbal extracts/elixirs" as the tradi-
tional/folk remedy of jaundice. "Exorcism/religious treatment"
as the remedy of jaundice opted by 51.7% respondents, whereas,
37.9%, 24.1% and 37.9% informed of "bathing under supervision of
a holly man", "applying herbal pulp on the body and head" and
"wearing sanctified talisman/necklace/wristband" respectively as
the traditional or folk remedy of jaundice. Whereas, the scien-
tific approach "ingesting sugar cane juice" practiced as remedy
of jaundice by only 3.4%.

41. Among the interviewed respondents, 96.6% described the tra-
ditional or folk remedy of hysteria through "exorcism/religious
treatment/religious rite", whereas, 86.2% stated the remedy as
"through use of "holly water/talisman etc." Curiously interest-
ing that 48.3% opted for "smelling burn chilly in the nostrils"
as the remedy for hysteria. Again 6.9% described the remedy as
"goddess Kali's worship"!

42. Among the interviewed respondents, 75.9% described "exor-
cism/religious treatment" as the traditional remedy for mental
retardation. Again another 82.8% opted for the use of "holly wa-
ter/talisman" as the traditional or folk remedy for mental re-
tardation in the rural Bangladesh. Remedy through spontaneous
process had been described by 51.7% of the respondents. "Kali
sadhan or special rite to satisfy the nymphs had been prescribed
by 6.9%, whereas, 17.2% opted for praying to Allah/God for the
remedy.

43. Among the interviewed respondents, 79.3% stated that they
feel shyness to be treated (going to doctor, telling to the fam-
ily members about the disease etc.

44. Among the interviewed respondents, 89.7% feel guilty if dis-
eased/possesses stigma if diseased.

45. Among the interviewed respondents 68.97% believed the dis-
ease as the punishment from the Allah/God.

46. Among the interviewed respondents, 93.1% described "ingest-
ing rotten/decomposed/contaminated" as the etiology of diar-
rhoea/Cholera/Bhedbami, whereas, 51.7% informed of "if anybody
special watches pt. to eat" as the etiology of diar-
rhoea/Cholera/Bhedbami. Curiously interesting "anger of sched-
uled local goddess Ola/Obba" and "Eating in odd time" had been
suggested by same proportions of the respondents (34.5% for the
both) and respectively. "Night/noon travelling after eating palm
cake" was stated as the cause by 31%.

47. Among the interviewed respondents, all (100%) described
"getting cold" as the etiology of respiratory infection. "Becom-
ing wet in rain/exposed to open space" and "Staying with a pa-
tient of cold/cough" both were described as the aetiologies by
72.4% of the respondents for the same.

48. Among the interviewed respondents, 79.3% described going to
"bad" places/coitus with prostitute or unknown person as the
etiology of reproductive tract infection and sexually transmit-
ted disease. About 51.7% informed of "sexual part-
ner/self/staying unclean/dirty" as the etiology of the same.
Pretty high percentages expressed their various superstitions as
the etiology of reproductive tract infection and sexually trans-
mitted infection (table). 46. Among the interviewed respondents,
72.4% claimed "coitus in pregnancy/repeated coitus". "Eat-
ing/drinking/herbal foods/extracts" and Inflicted with unseen
influence of black magic", both stated by 51.7% of the respon-
dents as the aetiologies of abortion in rural Bangladesh. Claims
like "Eating pineapple/leaf/papaya/carrot" had been described
respectively by 41.4% respondents.

49. Among the interviewed respondents, 79.3% and 72.4% claimed
etiology of jaundice as "possession by scheduled goddess (pachu-
Pachy)" and "black magic/ban or witchcraft or deploying evil
power" respectively. Staying in the wet places", "Ingestion of
excessive turmeric in food/working in the turmeric field", "at-
tending turmeric day in a marriage ceremony" etc described as
etiology by appreciable percentage of respondents.

50. Among the interviewed respondents, 75.9% and 72.4% claimed
"possession by spirit of dead died unnaturally" and "possession
by supernatural/evil power" respectively as the etiology of hys-
teria. All the responses seemed to be linked with their tradi-
tional myths.

51. Among the interviewed respondents, 58.6% and 48.3% claimed
"possessions by supernatural/"evil" power" and "black
magic/witch craft/deploying evil force" respectively as the eti-
ology of mental retardation. Mythical "going outside in kali
goddess night (Kali puja)" claimed by 37.9% as the etiology of
mental retardation. It is surprising that very few admitted that
they did not know the scientific etiology and nobody were reluc-
tant to tell something as etiology of "mental retardation".

52. Among the interviewed respondents, 82.8% claimed the etiol-
ogy as "fed with unconventional meat (of vulture, crow, fox
etc)" and 69% claimed "possession by supernatural/"evil" power"
as the etiology of madness. "Possession by the spirits of dead
died" comes here as etiology stated by 55.2% respondents." Black
magic/witch craft/deploying evil" and "Going outside in kali
goddess night (Kali puja)" claimed by 44.8% and 31% respondents
respectively as the etiology of madness.

53. Among the interviewed, 89.7% sated for the both "harm by
different religious/spiritual rite" and "harm through witch-
craft" as the etiology of "Ban"! About 79.3% respondents claimed
and justified etiology of their "ban" respectively as "black
magic with hair, nail/cloth of victim".

54. Among the interviewed respondents, 100% and 89.7% claimed
"doing harm by religious/ kali goddess rites" and "Black magic
with hair, nail, cloth of victims" respectively as the etiology
of black magic. Interestingly, 6.9% and 3.4% described the eti-
ology for the same as "others" and "impelling a doll for the
victim (Voodoo)" respectively which resemble closely with West
Indian or African Voodoo black magic.

55. Among the interviewed respondents, 72.4% and 58.6% claimed
"travel in inappropriate places in odd time" and "night travel
through the place of cremation" respectively as the etiology of
the "evil air". Goddess Kali again blamed for 41.4% response as
the etiology of "evil air"!

56. Among the interviewed respondents, interestingly 62.1%,
65.5% and 34.5% claimed etiology of "fearfulness" as "being
afraid by any means", "going outside or travel in night of new
moon" and "seeing cat or dog in village road or bush in night"
respectively. Goddess Kali puja night scored 37.9% response
among the people of all religion in rural area of Bangladesh.

57. Among the interviewed respondents, about 41.4% and 37.9%
opted for "quack/non-M.B.B.S. private doctors" and "private
M.B.B.S. doctors" respectively for treatment if have sufficient
money. Interestingly "government hospitals" accounted for only
about 10.3% respondents reflecting rural people's attitude to
these outlets.

58. Among the interviewed respondents, 82.8% and 79.3% informed
of the disease cured by Allah/God's wish and through proper
treatment respectively. About 31% described healing spontane-
ously indicating misconception related to grave public health
risk.

59. Among the interviewed respondents, it is of particular in-
terest, 93.1% informed that their source of health information
(whatever the qualities) is "imam/priest/religious personality",
whereas, 34.5% described "government health workers" for it.
Also of interest that NGO contributed only for 6.9% as the
source of health information.

60. Among the interviewed respondents, about 41.4% described
"private M.B.B.S. doctors" and about 34.5% informed of
"Quack/non-M.B.B.S. private doctors" as the best treatment pro-
viders. However, only about 13.8% thought "Government hospital"
as the best treatment providers.

61. Among the interviewed respondents, about 96.6% expressed
their dissatisfaction in treatment in government hospitals in
general.

62. Among the interviewed primary respondents, 69% informed
their cause of dissatisfaction as "behavior of the doc-
tors/staffs in government hospitals is not good and less care".
About 58.6% were dissatisfied because of unavailability of re-
quired medicines, whereas

63.1% showed their dissatisfaction due to absence of doctor in
the outlets/hospital. However, only 3.4% respondents are satis-
fied in government hospitals putting reason of having best doc-
tors there.

64. Among the interviewed respondents, about 55.2% admitted that
the disease could be healed through spiritual means. However,
about 44.9% did not agree in the issue.

65. Among the interviewed respondents, about 89.7% thought
male's permission was necessary for the treatment of female fam-
ily members.

66. Among the interviewed respondents who supported the view of
male's permission for female's treatment, about 38.5% respon-
dents put the cause as "males are the head of the family",
whereas about 23% put the cause as "Males are income earning ".
However, about 7.7% did not know why they advocated for the
male's permission!

67. Mean expense for the treatment of diarrhoea was notified as
about Tk. 70 where minimum and maximum were Tk. 50 and Tk. 100
respectively.

68. Mean expense for the treatment of pneumonia/grave respira-
tory infection was notified as about Tk. 180 where minimum and
maximum were Tk. 90 and Tk. 250 respectively.

69. Mean expense for the treatment of Reproductive Tract Infec-
tion (RTI)/Sexually Transmitted Disease (STD) was notified as
about Tk.266 where minimum and maximum were Tk. 100 and Tk. 400
respectively.

70. Mean expense for the treatment of abortion was notified as
about Tk. 591 where minimum and maximum were Tk. 150 and Tk.
1000 respectively.

71. Among the interviewed respondents, about 72.4% respondents
informed that they were never keen for modern treatment for
jaundice!

72. Among the interviewed respondents, 93.1% opted for "homeo-
path/Kabiraji/traditional healers" if got jaundiced! Again, the
rest 6.9% disclosed their desired treatment centers/healers as
"religious/spiritual healers" if become jaundiced!

73. Mean expense for the treatment of jaundice was notified as
about Tk. 340 where minimum and maximum were notified as Tk.
200.00 and Tk. 500.00 respectively.

74. Among the interviewed respondents, about 75.9% respondents
expressed that they were never keen to be treated with modern
medicines for "mental retardation", whereas, only about 13.8%
opted expressed their occasional keenness for modern treatment
for mental retardation.

75. Among the interviewed respondents, about 74.4% opted for
treatment outlets with religious or spiritual healers for the
treatment of mental retardation, whereas, only about 3.5% de-
scribed their choice in favor of government hospitals for the
treatment for the same disease.

76. Mean expense for the treatment of mental retardation was no-
tified as about Tk. 347 where minimum and maximum were notified
as Tk. 100 and Tk. 500 respectively.

77. Among the interviewed respondents, about 79.3% stated that
they were never keen for modern treatment in hysteria, whereas,
only about 10.3% opted for modern treatment for the same dis-
ease!

78. Among the interviewed respondents, about 72.4% described
"religious or spiritual healers" as their chosen treatment out-
let for hysteria, whereas, about 24.1% opted "quack/non-MBBS
private doctors" as the outlet for the same disease treatment.
Government hospital was chosen by about only 3.5% for the pur-
pose.

79. Mean expense for the treatment of hysteria was notified as
about Tk. 248 where minimum and maximum were notified as Tk. 100
and Tk. 500 respectively.

80. Among the interviewed respondents, about 82.8% were never
keen for modern treatment for "madness". Only about 3.5% opted
for "frequently keen treatment" for "madness".

81. Among the interviewed respondents, about 65.5% opted "reli-
gious/spiritual healers" as the outlet for the treatment of
"madness", whereas, only 3.5% opted "government hospitals" for
the same.

82. Mean expense for the treatment of "madness" was notified as
about Tk. 441 where minimum and maximum were notified as Tk. 150
and Tk. 600 respectively.

83. Among the interviewed respondents, about 86.2% stated that
they were never keen for modern treatment for "ban".

84. Among the interviewed respondents, about 82.8% had their de-
sired outlet as "religious/spiritual healers" for "ban",
whereas, 6.9% relied on "homeopath/Kabiraji/ traditional heal-
ers".

85. Mean expense for the treatment of "Ban" was notified as
about Tk. 407 where minimum and maximum were notified as Tk. 100
and Tk. 700 respectively.

86. Among the interviewed respondents, about 89.7% respondents
were never keen for modern treatment of "black magic" or "witch
craft".

87. Among the interviewed primary respondents, about 79.3% re-
spondents opted for "religious/spiritual healers" as their
treatment outlet, whereas, about 13.8% relied on "quack/non-
M.B.B.S. private doctors" as treatment outlet for the described
disease.

88. Mean expense for the treatment of "black magic" or "witch-
craft" was notified as about Tk. 428 where minimum and maximum
was notified as Tk. 100 and Tk. 700respectively.

89. Among the interviewed respondents, about 86.2% were not keen
for modern treatment of "evil air".

90. Among the interviewed respondents, about 82.8% opted for
"religious/spiritual healers" s the desired outlet for the
treatment of "evil air", whereas, only about 10.3% opted for
"quack/non-M.B.B.S. private doctors" and nobody opted for gov-
ernment hospital for the same.

91. Mean expense for the treatment of "evil air" was notified as
about Tk. 238 where minimum and maximum was notified as Tk.
100and Tk. 400 respectively.

92. Among the interviewed respondents, about 89.7% were never
keen for modern treatment for "fearfulness".

93. Among the interviewed primary respondents, 87% opted for
"religious/spiritual healers" as desired outlet for treatment of
"fearfulness", whereas, about 13.8% opted for "quack/non-
M.B.B.S. private doctors" as treatment outlet for the same dis-
ease.

94. Mean expense for the treatment of "fearfulness" was notified
as about Tk. 163 where minimum and maximum was notified as Tk.
60 and Tk. 300 respectively.

95. Among the interviewed primary respondents, about 58.6% re-
spondents described the above treatment costs as "not justi-
fied". A significant proportion (about 27.6%) responded as
"don't know"!

96. Mean transport cost of the patient to nearest hospital was
notified as about Tk. 44 where minimum and maximum was notified
as Tk. 30 and Tk. 60 respectively.

97. Among the interviewed respondents, about 58.6% informed of
their minimal required time for transferring the patient to
nearest hospital as less than 3 hours, whereas about 34.5% in-
formed that as more than 3 hours.

98. Among the interviewed respondents, about 62% thought that
"health problems" and diseases are not same (if not same, then
there were scopes for trying remedy otherwise than the treat-
ment! i.e. disease: more grave condition, problem: less grave
condition, so for the less grave condition, they can call tradi-
tional or spiritual healers for low costs mainly).

99. Among the interviewed primary respondents, 93.1% respondents
thought that the GoB doctors were "not enough dutiful and sin-
cere" with the patients.

100. Among the interviewed respondents, about 58.6% perceived
the "treatment environments in the GOB hospitals" as "not good",
whereas, about 27.6% responded as "don't know".

101. Among the interviewed respondents, about 75.9% thought that
GoB doctors "don't listen/counsel well the patients" coming for
treatment to the government hospitals. Again, about 10.3%
thought that the GoB doctors "listen and counsel well the pa-
tients" when they were paid with money! (Taking money is out of
rule for the doctors in Government hospitals and this response
showed the situation in the Government hospital!)

102. Among the interviewed respondents, about 65.5% respondents
admitted that the diseased person were experiencing abusing for
disease, whereas, 6.9% don't know anything regarding the issue.

103. Among the interviewed respondents, who admitted as above,
about 47.6% thought it was "because of the expenses of treat-
ment", whereas, about 14.2% described the causes as "because of
interruption in income earning/study" and "Because of interrup-
tion in income earning". 102. Among the interviewed respondents,
about 65.5% respondents thought that the family could decline to
treat its patients even having capacity for that.

105. Among the interviewed respondents, who admitted the above,
about 50.6% thought the cause as "for expenses of treatment",
whereas, about 26.3% thought the cause as "lack of aware-
ness/failure to perceive importance".

106. Among the interviewed respondents, about 17.2% thought that
they had "mental patient" within the family.

107. Among the interviewed respondents, who thought of having
"mental patient" within the family, nobody could tell the exact
prevailing disease (didn't know what is exactly the disease
was!).

108. Among the interviewed primary respondents, who thought of
having "mental patient" in the family, 40% were treated with any
means.

109. Among the interviewed respondents, 89.7% opted for "reli-
gious/spiritual healers" as the outlet for the treatment of
"mental patients", whereas, 65.5% voted for "quack/non-M.B.B.S.
private doctors" as the chosen outlet for the purpose. However,
the government hospitals accounted for 62.1%.

110. Among the interviewed respondents, about 51.7% described
the cause for the above choice as "psychological diseases can't
heal by modern treatment" whereas, about 37.9% described that as
"that healers were good for mental diseases"!

111. Among the interviewed respondents, about 86.2% thought that
the psychological diseases could not be cured fully, even with
proper treatment!

112. Among the interviewed primary respondents, 89.7% thought
"possession by supernatural evil forces" as the etiology of
"madness", whereas, 65.5% thought that as "black magic/ban/witch
craft/devil worship". Curiously interesting that "mental shock"
contributed for 10.3%, goddess Kali for a considerable propor-
tion of 44.8% and "fed unconventional meat/drinks
(kite/vulture)" for massive 44.8%.

113. Among the interviewed primary respondents, 82.8% thought
"possession by supernatural evil forces" as the etiology of hys-
teria, whereas, 58.6% that for "black magic/ban/witch
craft/devil worship". "Mental shock" contributed for 6.9% and
goddess Kali for 24.1%. "Bad wind" scored 69% for the disease!

114. Among the interviewed respondents, 58.6% admitted their
lack of knowledge regarding etiology of "non-responsiveness",
whereas, 41.4% thought the etiology of the disease as "posses-
sion by supernatural evil forces". "Bad wind", unconventional
meat and "mental shock" contributed for 34.5%, 34.5% and 6.9%
respectively.

115. Among the interviewed respondents, 69% thought "possession
by supernatural evil forces' and 65.5% "mental shock" as the
etiology of "mental depression"! " Black magic/ban/witch
craft/devil worship" contributed another 37.9% and goddess Kali
for 17.2%. However, 27.6% didn't know anything regarding the
etiology of "mental depression"!

116. Among the interviewed respondents, 75.9% confirmed "posses-
sion by supernatural evil forces" as the etiology of "agile',
whereas, 65.5% thought that was caused by unconventional meat.
"Black magic/ban/witch craft/devil worship" and goddess Kali
contributed for 44.8% and 31% respectively as the etiology for
the disease.

117. Among the interviewed respondents, each 93.1% described
their outlet for RTI/STD treatment as "homeopath/Kabiraji/ tra-
ditional healers" and 82.2% each for "religious/spiritual heal-
ers" and for quack/non-M.B.B.S. private doctors for the purpose.
Only 41.4% opted for government hospitals for their treatment of
RTI/STD.

118. Among the interviewed primary respondents, about 82.8%
thought that somebody didn't take treatment for RTI/STD as be-
cause that could be healed spontaneously, whereas, another about
17.2% thought that actually they had been treated through some-
body else who contacted doctors/healers on behalf.

119. Among the interviewed primary respondents, about 65.5% had
patients (of any disease) in the family (Point Prevalence of
Disease).

120. Among the interviewed primary respondents, who
had patient in the family, about 21%, about 15.8%, and about
26.3% had diarrhoea, jaundice, and respiratory tract infection
respectively as prevalent diseases.

121. About 52.6% respondents informed of their duration of sick-
ness more than a week, whereas 10.5% had the duration of sick-
ness as more than 15 days.

122. About 84.2% respondents who suffered from any disease in-
formed that they were treated for the mentioned diseases

123. About 43.8% respondents informed of their treatment through
"Quack/non-M.B.B.S. private doctors", whereas 25% respondents
did that through "Homeopath/Kabiraji/traditional healers".

124. About 75% respondents those were not treated correctly (as
perceived by the qualified doctors)