Browsing by Person "Lê, Gillian"

Now showing 1 - 2 of 2

Socio-cultural change in conflict and post conflict settings: Five decades of giving birth in Cambodia
(BioMed Central, 2019-11-15) Ros, Bandeth; Lê, Gillian; Fustukian, Suzanne; McPake, Barbara
Background: This paper explores the changing experience of giving birth in Cambodia over a 53-year period. During this time, Cambodian people experienced armed conflict, extreme privation, foreign invasion, and civil unrest. Methods: An historical perspective was used to explore the changing place and nature of birth assistance given to Cambodian women between 1950 and 2013. Twenty-four life histories of poor and non-poor Cambodians aged 40–74 were gathered and analysed using a grounded thematic approach. Results: In the early lives of the respondents, almost all births occurred at home and were assisted by Traditional Birth Attendants. In modern times, towards the end of their lives, the respondents’ grand-children and great grand-children are almost universally born in institutions in which skilled birth attendants are available. Respondents recognise that this is partly due to the availability of modern health care facilities but also describe the process by which attitudes to institutional and homebirth changed over time. Interviews can also chart the increasing awareness of the risks of homebirth, somewhat influenced by the success of health education messages transmitted by public health authorities. Conclusions: The life histories provide insight into the factors driving the underlying cultural change: a modernising supply side; improving transport and communications infrastructure. In addition, a step-change occurred in the aftermath of the conflict with significant influence of extensive contact with the Vietnamese recognised. Trial registration: None.
The commercialization of traditional medicine in modern Cambodia.
(Oxford University Press, 2017-10-11) Ros, Bandeth; Lê, Gillian; McPake, Barbara; Fustukian, Suzanne
Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60-years in Cambodia, a country with high out-of-pocket expenditures for health. The life histories suggest that traditional medicine in Cambodia has been undergoing a process of commercialization, with significant impacts on poor households. In the earlier lives of respondents, payments for traditional medicine were reported to have been flexible, voluntary or appropriate to patients' financial means. In contrast, contemporary practitioners appear to seek immediate cash payments that have frequently led to considerable debt and asset sales by traditional medicine users. Given traditional medicine's popularity as a source of treatment in Cambodia and its potential to contribute to household impoverishment, we suggest that it needs to be included in a national conversation about achieving Universal Health Coverage in the country. [Abstract copyright: The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.]