Bull World Health Organ. 1998 ; 76(2): 195-201.

[What determines the choice of health care treatment in the town of Contonou (Benin)?]

Gomes do Espirito Santo E, Floury B, CissÃ© M.

Households in Contonou show a clear preference for modern medicine. Self-medication is the first choice, followed by use of private practices, which are growing in importance in Benin as treatment options. This preference for private medicine seems to meet a demand that is not covered by the public services, which occupy the third place among treatment options. The hospital and the practitioner of traditional medicine are the last resort where the other choices have not produced the expected outcome. The choice of self-medication is determined by the patient's assessment that the illness is not serious, by the habit of using a certain treatment in response to a familiar symptomatology, and by the desire to avoid the expense of a consultation. The recourse to other options is connected with the geographical accessibility of the places of consultation, the cost of care and treatment, the reception accorded to patients at the place of consultation, the seriousness of the illness and, to a lesser degree, the relations of kinship with the health personnel in the services visited. The choice between the available health services lies principally between private clinics and public health centres. There is therefore a need to consider the operation of public health centres and the quality of the care they provide since this would enable those responsible for health service organization and planning to make better informed choices. At the same time, the state should encourage its research bodies to study the operation of the private sector in the light of the importance of this type of care in the treatment chosen by households.