Socio cultural factors are norms, values, beliefs, material and non material objects that are passed on from one generation to another in any given society .Socio cultural factors are crucial in any developmental aspect of a community.(Noyo Ndangwe p230) There is considerable interest in analyzing these factors that are impacting on human social service delivery and these are economic, religion, political and socio-cultural factors which are of special significance because of their tendency to shape the context or foundation for the operation of any other set of factors that operate upon human social service delivery.
In this regard, we will try to look at one factor, that is, Socio cultural factor how it is impacting on human social service delivery. First and foremost would like to define the key concepts this assignment. 1. Socio means interaction.
2. Culture means the beliefs, customs, practices, and social behaviour of a particular nation or people.
3. Factors mean something that contributes to or has an influence on the outcome of something.
4 Impacting means to have an immediate and strong effect on something or somebody.
5 Social Service These are welfare programs aimed at enriching human life 6 Delivery means taking something to somebody. The first to way to discuss this will be to try to analyse how socio-cultural factors affect the performance of Primary Health Care. There is now a large body of literature on the social and cultural determinants of health which ‘refer to both the specific features and pathways by which societal conditions affect health. The WHO has, for example, identified a number of socio cultural factors and conditions.
The list of factors includes (i) cultural beliefs and taboos, (ii) gender inequality, and (iii) the urban – rural divide. The socio-cultural factors impacting on health will differ between societies and even within sub-cultures within the same society. Thus the factors in a developed society will tend to differ from those that are operative in a backward, underdeveloped society.
Factors such as urban-rural migration, unemployment, education, gender inequality, lack of money, transportation, distance to health facility, cultural inhibition, fear of going alone to health facilities, inability to make informed choices and the need to obtain permission from some authority figure such as the husband in the case of some married women have been cited (Social Determinants of Health: Nigerian Perspective: 2005). Social cultural taboos and social meanings attached to certain diseases and their causes are other socio cultural factors that are impacting on service delivery. Cultural beliefs and taboos
Cultural beliefs and taboos impact upon the performance of the Primary Health Care in several ways. First, they shape forms of behaviour that lead to certain health outcomes. As an example, consider beliefs about fertility and family planning. People living in rural areas tend to want to have more children and not to want to use the more modern methods of family control (PHC, WHO: 2004).
This has implication for population growth, the incidence of child and maternal mortality and the number in the population seeking access to health care. As another example, we can also consider the case of beliefs about HIV/AIDS. Quoting a UNESCO Report, Kickbusch et al (2002:4-5) have observed that in some parts of Africa, ‘people believe that clean and well-dressed individuals cannot become infected or that having sexual intercourse with a virgin will cure AIDS’. Ladipo et al (2003) have also reported a study on the perceptions of Gate keepers, the custodians of cultural beliefs and moral norms, about sexuality and HIV/AIDS in Nigeria.
Using in-depth interviews with teachers, media representatives, religious, political and traditional leaders and focus group discussions among parents the study reported that the culture downplayed the sexual mode of transmitting the disease; ‘condom promotion was not accepted on religious grounds by most participants. Cultural beliefs not only also shape how individuals respond to forms of disease and illness but also choices about which forms of care should be accessed.
For example, cultural beliefs about certain forms of disease may lead to silence and denial thus creating veritable grounds for the continuation of behaviours and actions that promote the disease (Human Rights Watch, 2002). Studies of the social meaning of infertility in Nigeria have shown that beliefs about infertility play a determinant role in interpretation and treatment of infertility. Following these beliefs, most people used three treatment outlets: ‘churches (spiritualists), traditional healers and hospitals (orthodox medical treatment)’ (Okonofua et al 1997:211). Gender inequality
Gender inequality impacts the Primary Health Care system through its contribution to lower status, lack of empowerment, higher rates of illiteracy, and higher levels of poverty for women. As in the case of illiteracy, these factors translate into higher incidence of ill-health for women and paradoxically, their lower capacity to access health care. For example, women with less education have less control over their sexual activities and therefore also more affected by sexually transmitted diseases.
For example, HIV/AIDS which is transmitted largely through sexual activities is more prevalent among women than among men. The relative lack of control over their sexual choices also means that many more women get pregnant than should be the case. This has implications for fertility and maternal mortality rates. Women therefore have a higher need to access health care especially at the PHC level. Only women generally tend to need the permission of men to access health facilities.
Poverty is also higher among women in the population than men. These factors suggest that women will also have a lower capacity to meet their health needs even when facilities exist to provide for those needs. The urban – rural divide
The urban – rural divide is implicated in the differences in living conditions between urban and rural areas, in the distribution of the population between the two areas and in several other factors. Differences in these factors impact upon the performance of PHC in a number of ways. First, it imposes different challenges on PHC in urban and rural areas. It has been observed for example, that living conditions, especially with respect to the availability of electricity, good roads, water, transportation, communication, poverty and quality of life tend to be much higher in urban than rural areas (Imoudu, 1995).
The implication of this is the tendency for PHC units to be better staffed and equipped in urban areas than rural areas. It is thus not surprising to find that storage facilities for drugs are better in urban areas than rural areas (Gupta et al, 2004). Professional health personnels are also more reluctant to accept postings to rural areas. Another implication is the pattern and distribution of the disease burden between urban and rural areas. Given the fact that urban areas have more PHC facilities and that other secondary and tertiary health care facilities tend to be located in them, the health needs of urban populations tend to be better served than those of rural areas.
There will therefore tend to be more pressure on PHC facilities in rural areas. If we take into consideration the additional factor of higher poverty in the rural areas, the lower capacity of rural communities to access health care when they need it will translate into worse health indices in the rural areas than urban areas.
However it should be noted that socio cultural factors also impact positively in human service delivery in the following ways. Traditional medicines have become part or alternatives were modern medicine has failed.
That not all in certain areas use of socio cultural factors has enhanced social service delivery in the areas of ceremonies which bring in foreign exchange and general leading to an improved standard of life of the people.eg prior to the kuomboka ceremony of the lozi people of western province, roads are graded, buildings painted, the towns and villages cleaned hospitality industry also takes a new shape which is a plus in service delivery. CONCLUSION
Socio cultural factors are norms, values, beliefs, material and non material objects that are passed on from one generation to another in any given society. As we looked at how socio-cultural factors affect the performance of Primary Health Care we have noted that socio cultural factors are crucial in any developmental aspect of a community The socio-cultural factors impacting on health will differ between societies and even within sub-cultures within the same society.
The WHO has, for example, identified a number of socio cultural factors and conditions. The list of factors includes (i) cultural beliefs and taboos, (ii) gender inequality, and (iii) the urban – rural divide. The socio-cultural factors impacting on health will differ between societies and even within sub-cultures within the same society. Cultural beliefs and taboos impact upon the performance of the Primary Health Care in several ways. First, they shape forms of behaviour that lead to certain health outcomes. Gender inequality impacts the Primary Health Care system through its contribution to lower status, lack of empowerment, higher rates of illiteracy, and higher levels of poverty for women.
1. Dr. Festus Iyayi, (2009), Socio cultural factors impacting upon Primary Health Care in Nigeria, Department of Business Administration, Faculty of Social Sciences, University of Benin, Benin City, Edo State, Nigeria 2. Global Health Watch (2004) Global Health Action, edited by Whyte, A., McCoy, D and Rowson, M, Russell Press 3. Noyoo. N, (2000), Social Policies and Social Services in Zambia. UNZA Publishers, Lusaka, Zambia. 4. Oxford advanced learners dictionary (2002).