L’offre de soins à Vientiane (RDP Lao) : entre contrôle territorial et économie marchande

Espace, populations, sociétés 03/2006; 2(2006/2-3). DOI: 10.4000/eps.3243
Source: OAI


Since Lao PDR opened up to free market economy at the beginning of the 1990s, public health care has coexisted with a private one, which is strongly growing. The phenomenon is particularly obvious in Vientiane. This article aims at studying the structures and motivations of the spatial distribution of each of the two systems in the capital. With this intention, we listed and located the whole of these offers in the urban area and interviewed the various sanitary administrations. It appears that the location of health care is prompted by very different motivations according to whether it is public or private: the first aims at controlling territories, the latter is mainly motivated by the financial contributions implied.

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    ABSTRACT: While essential medicines have been made more available in all but the most remote areas in low and middle income countries (L/MICs) over the past years, inappropriate and incorrect use of good quality medicines remains a key impediment for public health. In addition, as medicines have a potential to cause harm (medicine risks), adequate awareness by medicine users of the risks of adverse reactions is essential, especially as self-medication is common in L/MICs. This study aimed to investigate the awareness of Lao residents regarding medicine risks in Vientiane Capital, Lao People's Democratic Republic. Face-to-face interviews using structured questionnaires of 144 residents older than 16 years were carried out in 12 randomly selected villages out of the 146 villages of Vientiane Capital with at least one health facility. The respondents were mainly (85.0 %) the heads of households or their husband/spouse . The majority of the respondents were unaware (61.8 %) of medicine risks. Compared to residents living in the urban district of Xaysetha, living in peri-urban and even more in rural areas were identified as factors associated with being unaware of medicine risks [adjusted odds ratio (aOR) =3.3, 95 % Confidence Interval (CI) = 1.1-9.4]) and aOR =7.5 (95 % CI = 2.3-24.2), respectively]. In addition, more than half of the respondents had never heard of poor quality medicines, with a higher rate in rural/peri-urban compared to urban districts (55.6 % vs 38.9 %, respectively, p = 0.02). Finally, approximately one third of all respondents thought that traditional medicines could not cause harm. Overall, these results suggest a lack of awareness about medicinal product risks. Differences according to the place of residence are apparent and could be partly explained by a lower level of training of healthcare providers in contact with the population in the rural districts in particular. Communication on medicinal product risks to patients through well-trained healthcare providers could probably make a valuable contribution towards the appropriate use of medicines in L/MICs.
    Full-text · Article · Jun 2015 · BMC Public Health