Perceived ill-health and health seeking behavior in two communities in the nam theun 2 hydroelectric project area in Lao People's Democratic Republic

Objective: To compare perceived ill-health and health seeking behavior between two communities affected by the large Nam Theun 2 hydroelectric project in central Lao People's Democratic Republic (PDR). Methods : Two different affected areas; Nakai plateaubeing remote, sparcely populated and mountainous, and Xe Bang Fai lowland plains, more densely populated and comparatively affluent were included. Data were obtained from two cross-sectional household-based health and socio-economic surveys. Results We found pronounced differences in the frequency of self-reported fever, cough, headache and myalgia according to location. On the Nakai plateau, 45.1% of the individuals with ill-health report (recall period: 2 weeks) went to a local health volunteer compared to only 7.2% in the Xe Bang Fai area (P > 0.001). In Nakai, there were disproportionately more illiterates seeking help from local health volunteers when compared to those who attended at least primary schooling (49.2% versus 17.5%, P > 0.01). Self-medication with antimalarials was more common in Xe Bang Fai than on Nakai (32.3% versus 7.0%, P > 0.001). The mean amount of money spent per health consultation was US $ 1.7 in Nakai and US $ 7.2 in Xe Bang Fai. Conclusion :The observed differences in self-reported ill-health and health seeking behavior among these two Lao communities need to be considered when implementing setting-specific mitigation measures as part of the public health action plan of the Nam Mean 2 hydroelectric project