title: Health-seeking behaviours of older black women living with non-communicable diseases in an urban township in South Africa.
abstract: BACKGROUND
  Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE).
  
  
  METHODS
  A homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250). Descriptive statistics were used to examine the number of NCDs reported by the study sample, health seeking behaviour and practices as well as THM use. Logistic regression was also employed to investigate possible associations between reported conditions and THM use or medical pluralism.
  
  
  RESULTS
  Within the study sample, 72 % self-reported an NCD. Of those with self-reported NCDs, 46 % had one, and 54 % had two or more NCDs. Those with NCDs usually visited public clinics (80 %), relied on doctors (90 %) and nurses (85 %) for health information, and mostly used conventional medicine (CM) to manage high blood pressure (81 %). About 30 % of those with NCDs indicated using THM, of whom 29 (53 %) reported practicing medical pluralism. Participants with dental problems (OR: 3.24, 95 % CI: 1.30-8.20), headaches (OR: 2.42, 95 % CI: 1.24-4.94), heart burn (OR: 2.30, 95 % CI: 1.18-4.48) and severe tiredness (OR: 2.05, 95 % CI: 1.08-3.99) were more likely to use THM. Anxiety and allergies increased the likelihood to practise medical pluralism by five and 20 times, respectively.
  
  
  CONCLUSIONS
  Self-reported NCD with co-morbidities was prevalent among the participants in the study. Most of the study participants utilized state-owned clinics and hospitals for the management of their chronic conditions. THM use was not very common. However, among those who used THM, medical pluralism was prevalent. Family history was the most common reason for THM use, with many THM patrons utilizing these for treatment of a health condition. Older black women with anxiety and allergies were more likely to practise medical pluralism.
authors: South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville, South Africa.|Present Address: Department of Pharmaceutical Sciences, Tshwane University of Technology, Arcadia, Pretoria, South Africa.
authors: O M
authors: OM
authors: Aboyade
authors: The South African Department of Science and Technology/National Research Foundation (DST/NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa.|International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.
authors: R
authors: R
authors: Beauclair
authors: School of Pharmacy, University of the Western Cape, Bellville, 7535, South Africa.
authors: O N
authors: ON
authors: Mbamalu
authors: School of Public Health, University of the Western Cape, Bellville, South Africa.
authors: T R
authors: TR
authors: Puoane
authors: South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville, South Africa. ghughes@uwc.ac.za.
authors: G D
authors: GD
authors: Hughes
mesh_terms: D044383:Black People / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016488:Medicine, African Traditional / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D008517:Phytotherapy / Q000706:statistics & numerical data; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Medical pluralism; Non-communicable diseases; Older women; Traditional herbal medicine