[Natural histories of disease: a pragmatic approach to multidisciplinary research on health care seeking behavior and therapeutic itineraries].

Public health is determined by the interaction of social, cultural and biological factors. Because of this complexity, a multidisciplinary approach is needed when doing research on public health problems. Medical anthropology and epidemiology share a common interest for human behavior and health, so it is especially appropriate for these two disciplines to work together in studying health seeking behavior and the use of health systems. In order to better understand social and cultural factors associated with health seeking behavior, a suitable qualitative research method was needed for use in association with a medical and epidemiological approach in the research program "Use and perception of health systems by children and their family", carried out in Algeria, the Congo (Brazzaville), Morocco, and Togo. Three factors were considered important: coordinating the qualitative and quantitative research methods within a single time frame, involving all members of the multidisciplinary research teams in each country, and producing data accessible and useful to health care professionals and others responsible for health system performance. A case study method based on "natural histories of illness" was adopted, using home interviews of families about a recent illness episode of an under-5 child. There are several advantages to this approach: 1) analysis of illness episodes reveals the totality of the health seeking process, including therapeutic itineraries; 2) families have little difficulty in describing an illness episode in the order events occurred; 3) these accounts are easily understood by health professionals, resembling as they do a "clinical case study" approach; 4) the content is readily available in the form of common discourse for use by health program planners and administrators. The method is thus able to provide information necessary for organizing health services which meet the perceived needs of the population.