Choosing among therapies: Illness behavior in the Ivory Coast

After reviewing the wide variety of medical systems available to inhabitants of the Ivory Coast, the results of utilization surveys of town and village residents are presented. They support the position that the choice of therapy depends more on its accessibility than on any characteristics of the individual patient. The accessibility of the different kinds of medicine is analyzed in terms of time delay, cost, and communication problems, and reasons for the inaccessibility of Western services are discussed. The choice of Western medicine is inhibited not by “unscientific attitudes”, as many social scientists have suggested, but rather by the political and economic forces which limit the usefulness of these services and by the availability of attractive alternatives.