Socio cultural aspect of health

Dr. Alok Acharya

Assistant Professor
Community Medicine

02/28/2024 Dr. Alok Acharya

Learning socio cultural aspect of health have a great
advantage of gaining fresh insights and practical
benefits in personal and professional practices of
medical students

02/28/2024 Dr. Alok Acharya

• Epidemiologists and anthropologists attempt
to address fundamental questions as:
– What is the evolutionary basis of the difference in
how various populations contend with disease?
– What are the essential factors influencing the
growth and development of children?
– What effect does modernization have on local
populations? (Howard and Dunaif-Hattis 1992)

02/28/2024 Dr. Alok Acharya

The determinants of health as set out by Dahlgren and Whitehead (1992)

02/28/2024 Dr. Alok Acharya

Social determinants of health and pathways to health and well-being
adapted from Brunner and Marmot (2006)

02/28/2024 Dr. Alok Acharya

Key social determinants of health that are directly applicable to Nepal

02/28/2024 Dr. Alok Acharya

 Ecological model for health promotion
• Focuses attention on both
individual and social environmental factors
as targets for health
promotion interventions.
• It addresses the importance of
interventions directed at changing
interpersonal, organizational, community,
and public policy, factors which support and
maintain unhealthy behaviors.
• The model assumes that appropriate
changes in the social environment will
produce changes in individuals, and that the
support of individuals in the population is
essential for implementing environmental
changes."
02/28/2024 Dr. Alok Acharya
 Social and cultural Taboos
• Belief system is strongly associated with the socio-
cultural practices, family orientation, social
environment, schooling of people.
• Some of the false belief and harmful practices are
associated with the Chhaupadi system of Nepal.
• Chhaupadi is a social tradition related to "menstrual
taboo" in the western part
of Nepal for Hindu women, which prohibits them
from participating in normal family activities during
a menstruation period, as they are considered
02/28/2024 Dr. Alok Acharya
• Many believe that pregnancy is a natural
condition that does not need any particular
attention.
• Any special treatment of mothers tends to be
for the protection of the unborn child rather
than for her own health and well being.
• One widely held belief is that if a woman eats
more during pregnancy she will have a bigger
baby which can cause problems during labour.
02/28/2024 Dr. Alok Acharya
• Social factors also influence the diet of pregnant women:
– women and girls usually eat after male members and children
have eaten and have less access to food from animal sources
and other special foods.
– Mothers who have recently delivered a baby are considered
impure and are not allowed to eat with other family members
until the purification ceremony has been held. In some
communities, mothers’ food intake is limited during this
period.
– Women in mid and far western hill regions practice a system
in which the recently delivered women are kept in the
cowshed outside their homes in very unhygienic conditions.

02/28/2024 Dr. Alok Acharya

– In some cultures, it is believed that a connection
between stomach and womb exists and womb and
stomach are rested together by not giving food to the
mothers.
– For mothers in many families, the diet for lactating
mother is the usual family diet because they can’t afford
different foods. The diet for a lactating mother is further
restricted when her baby is ill.

02/28/2024 Dr. Alok Acharya

• Some babies start solid foods after the rice feeding
ceremony at five or six months. Many children are
given a family diet without any special preparation.
• If the infants or children don’t show any interest in
solid foods, mothers may not persist with feeding
the infants.
• The complementary foods generally lack variety:
they are often based on rice and dal. Meat, fish, or
eggs are infrequently given to the children.
02/28/2024 Dr. Alok Acharya
• Some food items like green leafy vegetables are
considered cold and are not given to infants or
children.
• Constraints to appropriate and adequate infant and
child feeding include maternal malnutrition;
seasonal food insufficiency, mostly during monsoon;
and maternal workload

02/28/2024 Dr. Alok Acharya

Thanks   

02/28/2024 Dr. Alok Acharya