Soc Sci Med. 1983 ; 17(3): 177-87.

Movement for medical treatment. A study in contact patterns of a rural population.

Ramachandran H, Shastri GS.

This paper deals with the patterns of movement of rural population for purposes of medical treatment. The following hypothesis are empirically tested with the data on 245 randomly selected sample villages containing about 30,000 households in Tumkur District of Karnataka (India). (a) There are significant differences in the incidence of sickness between various socio-economic groups. (b) The poorer sections of the rural society tend to get treated by informal/traditional systems of medicine. (c) Since the available medical facilities are few, no significant differences are observable in the distance travelled by different socio-economic groups. (d) The actual places of visit for treatment may be different for different socio-economic groups, since the society consists of 'status-conscious' population. (e) The long distance movement is not a matter of travel costs but essentially of overhead costs at the places of treatment. The analysis reveals that hypothesis (c), (d) and (e) are valid. Invalidation of hypothesis (a) raises the question of perception of sickness among the various strata of the society, whereas invalidation of hypothesis (b) indicates the use of allopathic system by all sections of rural population. In terms of location planning of medical services, the study indicates that two levels may be thought of--neighbourhood facilities and higher order facilities--rather than a hierarchy of medical centres involving a number of intermediary levels. Middle level centres are found to be under utilised since the patients tend to bypass them to avail of medical services of higher order centres.