Health care in sedentarising communities : a case study in the Jordan Badia
The World Health Organisation's (WHO) 'Health for All by the Year 2000' (HFA2000) resolution is intended to promote improvements in the equality of health care provision, the basis of which is universal accessibility to basic health care. The Jordanian Government, in accordance with HFA2000, has attempted to improve accessibility in rural communities by providing an extensive network of basic rural health clinics which are intended to be acceptable and accessible to all communities. Within this context, the research considers two interrelated themes. The first theme considers changes in health and illness practices, and particularly the wide-scale and rapid acceptance of modern medical services at the same time as `traditional' Arabic medicines are becoming relatively unimportant in the north east Badia. This study highlights the connections between health and illness discourses in the past, Bedu social values, and the wider social economic milieu, and how these are reflected in the forms and use of Arabic medicines. The literature widely assumes that culture, `traditional' social structures and attitudes inhibit the acceptance and effective utilisation of modern medical services, and that education, for example, is a key way to address this problem. This research engages with this assumption by evaluating the significance of social values, education and health awareness programmes, knowledge of health issues, together with socio-economic changes in explaining the acceptance of modern medicine and the adoption of preventative medicine and practices, together with changing attitudes to children's health. The second key theme of this research is to examine the extent to which basic government health services have been made accessible to the nomadic, sedentarising and settled rural population of the north east Jordan Badia, and specifically their children, a particularly vulnerable group, and whether this explains patterns of health and illness behaviour. To this end, the importance of geographical, organisational (health service), economic and social factors is evaluated in explaining variations in accessibility mediating the effective utilisation of these services at family level.