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Abstract
Expectations that low-resource communities will adopt health behaviours developed in high-resource settings will fail unless the uniqueness of the traditional local social and cultural systems are considered. These systems should inform health promotion specifically for Vanuatu. This thesis examines the socio-cultural aspects and health-seeking practices of mothers and caregivers for general health and handwashing in Vanuatu.
Ethnographic interviews were conducted to elicit descriptions of Ni-Vanuatu mothers’ and caregivers’ concepts of illness and health-seeking for children. Social network analysis was used to identify their health communication pathways and network structures for key people in rural and urban areas for handwashing promotion related to diarrhoeal diseases.
Both ethnographic interviews and social network analysis revealed that biomedical treatment was accepted by mothers and carers as providing higher levels of treatment for severe diarrhoeal disease in small children. It was the preferred option rather than the traditional medicine and this preference included the current Ni-Vanuatu female healthcare worker. The healthcare worker was the popular option (25/44, 57%) for perceived minor illness in small children in the rural network. Interviews identified that handwashing information was not discussed in either the rural or urban communities but general health information was sourced outside their urban network for 30% (10/33) of urban mothers and caregivers. The network for general health information for 70% (23/33) of the mothers and caregivers was highly dispersed without a specific pattern and included localised traditional relationships (kin) and friends and biomedical healthcare practitioners.
Local biomedical Ni-Vanuatu healthcare practitioners were the accepted point of care for health and socio-cultural information in both urban and rural mothers and carers. But these biomedical health providers are not providing preventive handwashing information and are accessed late in health provision for children with severe diarrhoeal disease. Therefore, to facilitate messages about preventive handwashing promotion, traditional healers, change agents and opinion leaders should be recruited to supplement biomedical health messages and diffuse health information and handwashing behaviour.