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After initiating health sector reforms in 1994, the Bénin government established the Integrated Family Health Project, known as PROSAF. Funded by the U.S. Agency for International Development, PROSAF operates in the Borgou region, which is mostly rural and has the country’s most severe health problems. PROSAF managers wanted to understand why local people were not using health services, despite their poor health. As noted in this brief, managers requested that the African Population and Health Research Centre (APHRC) study the way households and communities make decisions on health care. In a study conducted in 2000 with support from the Population Council, APHRC identified sociocultural factors that might impede access to health care in the region and recommended approaches to overcome these obstacles. Study findings included that adult men make unilateral decisions in household resource allocation and health care; people prefer alternative health care, mainly traditional healers or self-medication, because of their low cost; use of modern medicine tends to occur as a last resort, and only when symptoms are advanced; communication about FP is limited, both between husbands and wives and between parents and children.


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Frontiers in Reproductive Health