Timor-Leste Health Care Seeking Behaviour Study - Secretaria de ...

Appendix 4 – User-provider interaction during consultation; extract from userinterviewThis narrative highlights issues of trust and communication emerging in a consultation setting andresulting in the patient being discouraged from attending the health facility. The mother is upset thatthe provider asks her whether she is feeding her child, and the provider is upset that the motherdoes not appear to have taken his advice (which she cannot follow because the foods he has chosento recommend cannot be procured locally). The narrative also flags the issue of physical distance tothe health facility discouraging preventive care in that the mother perceives that her child’scondition will deteriorate during the course of the journey.Did you get what you expected in your consultation with a health provider earlier?I went there [village-level health post] to have my child weighed as the nurse spoke about thebaby’s weight. At the time of weighing if the child’s kilograms do not increase I feel upset andembarrassed. I feel [this], sometimes others call me to go [to the health post] and I ambreastfeeding so I can’t prepare breakfast, when they call I have to go, the baby’s kilograms do notincrease.What do you mean by upset/embarrassed?Upset that the child’s weight does not increase, we worry that the child will be sick or something.We’re scared, worry because it is far, and we must leave to walk [to the health post] at dawn, thefault is with us as mothers, at dawn the child has not yet done wee or poo, not yet eaten and thiscauses no weight gain.According to you, if the child has not eaten this is what causes the child not gaining weight?Because leaving at dawn causes this. The child has not yet done wee or poo, food has been givento the child but the child has not eaten and is just taken and must endure the journey.What did you understand that the nurse told you?One month the child’s weight increases, the next month it decreases. The nurse asks: did you feedthe child, or not? [He says] if the child does not eat, give vitamins. The nurse says this month thebaby’s weight has decreased, did you feed the child or not.How did the provider treat you?They indicate that they accept me well enough, when the child’s weight does not increase [theyare] angry. [They ask] Where did you go that you did not feed your child?Did you want the provider to treat you differently than they did?I am just thinking about my child, if your child does not eat, what can you do? You can cook leafygreens and eggs so that the child’s grams can increase. It is the nurse who directed me if there isfish, give to the child. Not continuously through the month but weekly. The child’s weightdecreased. This month I was going to return [to the health post] but I didn’t go because the child’sfather was busy. The nurse directed me to go to the health post but the child’s father was busy soI did not go.Did you follow what the nurse said?When I have these things, I can follow the instruction. I raise chickens but there is no fish. I havetomato and greens … [unfinished sentence].CONT.Timor-Leste Health Care Seeking Behaviour Study | 200964