Mothers' management of childhood diseases in Yorubaland: the influence of cultural beliefs

Health Transit Rev. 1997 Oct;7(2):221-34.


Several studies have noted that, besides inadequate availability of health care services in many areas, especially the less developed countries, certain disease-specific and non-disease-specific cultural beliefs may influence people's health seeking behaviour. It has even been noted that health services may be underutilized and several health and child care instructions may be ineffective or ignored in traditional and transitional societies where people's ideas and behavioural patterns conflict with the knowledge being passed to them (Feyisetan and Adeokun 1992; Feyisetan 1992). Feyisetan and Adeokun (1992) argued that non-adoption of modern preventive and curative measures cannot be attributed to poverty alone since the costs of some preventive and curative measures are not exorbitant in several of these societies. Rather, they suggested that the gap between awareness of modern health measures and health seeking behaviour must be sought in the social and cultural determinants of behaviour in such matters as child care and disease management. Earlier studies have noted that children in Nigeria die mainly from malaria, diarrhoea, measles, neonatal tetanus, whooping cough, tuberculosis, and bronchopneumonia (Morley and MacWilliam 1961; Ogunlesi 1961; Morley, Woodland and Martin 1963, 1966; Baxter-Grillo and Leshi 1964; Animashaun 1977; Tomkins 1981). Because these diseases are preventable at low cost to the individual, there is a need to investigate why large percentages of children are still subjected to many episodes of these diseases. In this paper, we examine (1) the mothers' perceptions of the aetiology of the three most cited childhood diseases in our study areas, measles, diarrhoea and fever, and the effect of these perceptions on the mothers' suggested curative measures; and (2) the persistence of the belief in abiku and how this cultural belief can influence mothers' management of childhood diseases. Since, for most mothers, perceptions of the aetiology of the childhood diseases are rooted in cultural beliefs, a brief review of disease-specific cultural beliefs is undertaken. In order to determine the effect of socio-economic factors, the mothers' perceptions of the aetiology of the childhood diseases, their recommended curative measures and the belief in abiku are examined according to selected socio-economic variables.

PIP: This study examines data from a two-round survey undertaken in September 1991 and April-May 1992 in Nigeria to reveal the "Impact of Cultural Beliefs and Practices on Child Health among the Yoruba." Data were analyzed to determine 1) mothers' perceptions of the etiology of measles, diarrhea, and fever and the effect of these beliefs on which curative measures they suggested and 2) the persistence of the belief in "abiku" (special children who have come from the spirit world and can die at will unless certain rituals are performed) and how this belief can influence the way mothers manage childhood diseases. The data for this study, collected via formal interviews with 1559 respondents supplemented by in-depth interviews and focus group discussions, were submitted to simple cross tabulation and logistic regression analysis. It was found that 1) many of the mothers lack accurate information about the causes of the selected childhood diseases, especially measles; 2) many of the mothers nevertheless recommended modern curative methods; 3) the belief in abiku remains strong among these mothers; and 4) the curative measures adopted by a mother may depend upon whether the sick child is believed to an abiku. Over half of the mothers believed that an abiku required treatment from traditional healers and religious institutions irrespective of the nature of the illness. Thus, the probability of a child receiving modern curative treatment depends upon whether or not that child is perceived to be abiku. This study underscores the need to consider local beliefs and practices when implementing health policies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Culture*
  • Diarrhea*
  • Female
  • Fever*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Measles*
  • Middle Aged
  • Mothers*
  • Nigeria