Cultural construction of health and institutional measures of change in rural Bangladesh: cases of BRAC's village organization and ICDDR,B's MCH-FP programmes.

The study aims to examine the perceptions, causes, and treatment of diseases among the people of a few selected villages in Matlab and their relation to traditional culture and interventions made by BRAC and ICDDR,B in the form of rural development and MCH-FP programs. Four sets of villages were chosen purposively--two DSS and the other two non-DSS. In one of the DSS villages the MCH-FP program is underway, while the other does not have such programs. Likewise, one of the non-DSS villages has the rural development program of BRAC, while the other does not have any. From each village 10 respondents were selected purposively to gather information. The perception of disease is mostly defined in terms of the functions of the body. On very few occasions it is defined in terms of the action rendered by germs or the pathological condition of the body organs. The difference between the meaning and the actual diseases is often blurred. While identifying the causes, often the reference is made to invisible spirits, locally known as alga batash. The modes of treatment combine both modern and traditional elements. However, the health teaching educates them about the perception, causes, and treatment of certain diseases. In society, the elderly people, religious preachers, and traditional healers play important roles to influence the mind of the people. Sometimes gender relations and other structural features also bear on the minds of the illiterate poor. The difference between the intervention and non-intervention villages is expressed in the fact that the people of the intervention villages are constantly exposed to the agents making changes, while in the non-intervention villages it is intermittent. Traditional culture still plays an important role in the construction of disease perception and the choice of treatment, while modern approaches are combined with it. The intervention procedures widen modern approaches but could not eliminate the traditional notions altogether.