Who Decides Our Health in Traditional Societies?

In rural and traditional societies, the perception of who controls health deeply influences medical choices. A survey conducted among 293 agro-pastoral farmers in Namibia reveals that the majority attribute their health to external figures rather than themselves. Doctors and divine entities occupy a central place in their beliefs, while the sense of personal control comes last.

This study shows that the more individuals are integrated into the market and exposed to the modern economy, the more they develop an internal sense of control over their health. Conversely, in the most isolated areas, trust in external authorities such as doctors or divinity prevails. A surprising finding: those who believe they have the most control over their own health are more skeptical of vaccines. On the other hand, those who place great importance on the role of doctors adopt a more favorable attitude toward vaccination.

Researchers also observed that market integration changes health beliefs. In rural areas, external sources of control are seen as more determining. This suggests that public health campaigns focused on individual autonomy may be less effective in these contexts. In contrast, involving respected authority figures, such as doctors or community leaders, could strengthen the acceptance of preventive care.

The survey also highlights that distrust of medical systems, often inherited from colonial history, plays a key role. The populations studied express general confidence in vaccines, but this trust varies depending on the type of vaccine and the level of distrust toward institutions. For example, COVID-19 vaccination raises more reservations than vaccines against tuberculosis or malaria, which are perceived as less political.

These findings invite us to rethink public health strategies. Rather than relying solely on individual autonomy, it would be more relevant to build on local trust networks and shared beliefs. Understanding how traditional societies perceive control over their health allows us to adapt messages and improve access to care, taking cultural and historical realities into account.

Bibliographie

Source de l’étude

DOI : https://doi.org/10.1186/s44263-026-00251-4

Titre : The power of powerful others: health locus of control and vaccination behavior in rural Namibian pastoralists

Revue : BMC Global and Public Health

Éditeur : Springer Science and Business Media LLC

Auteurs : Sean Prall; Brooke Scelza; Aparicio Lopes