A sociological analysis of the organisation, distribution and uses of health care in Mauritius
[Thesis]
Parahoo, A. K.
Bellaby, Paul
Keele University
1985
Thesis (Ph.D.)
1985
The main causes of morbidity and mortality in developing countries are infectious and parasitic diseases and malnutrition. While there is a growing consensus among health workers that these diseases are in the main preventable, approaches to health care have so far been curative. Health services are urban based while the majority of the popuLation are rural dwellers. This thesis examines in some detail colonial and post colonial health policies, the Primary HeaLth Care concept and the alternative approaches of L. DoyaL (1979) and V. Navarro (1976). In the light of these theoretical approaches, the organisation, distribution and uses of health care in Mauritius are analysed. CentraL to the methodology is a structured interview on socioeconomic factors, administered in 1979 to 100 families with infant/child death (4 weeks - 5yrs). The fieldwork, comprising extensive interviews with both laymen and health professionals, covered the period between October 1980 and May 1981. The analysis shows that while services have improved in scope, access to, the health system inherited from colonialism has undergone little structural change. Diseases such as Malaria, Small-pox and the Plague have been eradicated. Tuberculosis and Typhoid are under control. Life expectancy has increased while infant mortality has declined considerably. At the same time infectious diseases remain the main causes of mortality and morbidity in infancy and childhood. Besides infections, adults also face increasing risks from the diseases of the circulatory system and carcinomas. Curative services consume over 80% of health resources and remain concentrated in the urban areas. Unemployment is growing while the gap between the rich and the poor has widened in the last twenty years. There are indications of higher infant mortality associated with low income. A preventive and community approach to health care is called for. More co-ordination between the Ministries and an improvement in the living conditions of the poor will further enhance the health status of the Mauritian population.