Abstract
The main focus of this qualitative research was to explain folk and popular health care systems concerning promoting health of the middle-aged women residing in Lanna society. Study settings included an urban community, a semi-urban were 55 women, aged between 40 and 59 years old, and nine practitioners working in folk medicine. Data were obtained through the use of focus group discussions, in depth interviews, and participation and non-participation observation. Data were analyzed using content analysis, indicating the main themes, categorization, and mapping the connections. The major results of this study indicated that there were three alternative health care systems for middle-aged women: popular, traditional, and modern health care systems. Regarding the definition of health, the middle-aged women defined ‘health’ as a multi-dimensional aspect including the dimension of physical, mental and physiological function. Therefore, good health, according to these women, was referred to the state of physical fitness, being free from disease, good and happy mind, and being able to function activities. It is also interesting to note that marital status and child bearing was indicated to influence women health. In the period of middle-aged, the women preferably called as “golden age”, a period of various changes had been occurred physically, mentally and emotionally. Some women might call this age as “confusing age” because of uncertainty concerning whether the way they acted was appropriate. Further, the middle-aged women perceived that their age was high risk of developing disease and was irritability. Regarding the management of the physical changes, it was found that the management was depending on the severity of the symptoms. For mild symptoms, there was no special activities performed. Some women used daily activities, traditional herbal sauna, and Thai traditional massage. In case of having severe symptom, the women preferred to seek help from modern health care services, either public or private sector. It the treatment was unsatisfied or ineffectiveness, they would further seek help from traditional practitioners. Concerning the management of mental and emotional changes, almost all middle-aged women stated that they preferred to do mediation, hobbies and listen to Buddha teaching. It worth to note that the concept of health promotion among the middle-aged women was not clearly defined. Nevertheless, they pointed out many activities leading to good health. These were taking good nutrition, exercise, doing leisure activities, and taking tonic medicine or folk medicine. Hence, the results indicate that to promote health of the middle-aged women, it is of great important to modify health care service policy from curation to health promotion and disease prevention. This is anticipated to develop the concept of health responsibility among the middle-aged women. The modern health care services, therefore, should focus on primary or secondary prevention rather tertiary prevention, and such services should be in accordance with culture, beliefs and lifestyle of middle-aged women.
