Therapeutic itineraries: the medical field in rural Burkina Faso.

The health care system in Burkina Faso presents a paradox. The number of health centres in the rural areas has increased significantly since the signing of the Alma-Ata Declaration in 1978. However, studies show that these public health facilities are grossly under-utilized. Parallel to this development, local healers of different types are numerous and popular, and self-treatment extremely common. The present study explores this paradox on the basis of fieldwork in three villages in south-east Burkina Faso. Drawing on Bourdieu's notions of field and capital, the local health care system is analysed as a medical field where the different types of healers and health care institutions position themselves and are positioned through villagers' choice of therapy in their health seeking processes. The popularity of self-medication and various types of local healers are discussed in relation to the strengths of the various forms of capital in the medical field. It is argued that both local social relationships and indigenous knowledge are important variables in this particular area and add to our understanding of the low utilization rate of the public health facilities.