Medical pluralism and infant mortality in a rural area of Bangladesh

This paper examines some aspects of the health search behavior of parents in a rural area of Bangladesh who were unsuccessful in their attempt to save their infant's life. This issue is analyzed within the pluralist medical milieu and very high infant mortality rates prevalent in Bangladesh. There are several different medical cultures in Bangladesh each with their distinctive ideologies about disease causation and the nature of medical intervention. Practitioners of the modern cosmopolitan or western system of medicine are only one of the major types among several types of healers. The choice of a healer by the parents of infants is a complex process depending on a great variety of conditions such as the health status of the infant, relative proximity of the healer, cost of health care, transportation facilities, gender of the infant, attitude of the parents toward different systems of medicine, the past experience of the parents and the like. We posit that the choice of healer of a particular type may be related less to the traditional or modern orientation of the parents than to the severity of the infant's condition and the expectancy of cure. Thus, infants exhibiting acute symptoms of a disease may be more likely to be placed under the care of a 'western' type physician than taken for treatment to an indigenous medical practitioner. Such attitude on the part of the parents may, however, result in the loss of precious time at the most critical moments, and thus may reduce their chances of success to save their infant's life. The introduction of 'Palli Chikitshok' (village doctor) may have had some impact on the reduction of infant mortality by bringing preventive measures within the reach of village communities.