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TU Sociology 14th Batch Answers

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Complete Answers - TU Medical Sociology & Anthropology (14th Batch)

SECTION 1: Nature, Scope & Concepts

Q1. Basic concepts of Sociology & Anthropology and application in the medical field

Sociology (Auguste Comte, 1838) studies human society, social relationships, institutions, and change. Key concepts: social structure, norms, institutions, stratification, socialization.
Anthropology studies humankind in totality - culture, biology, language, history. Four sub-fields: cultural, physical, archaeological, and linguistic.
Applications in medicine: understanding social determinants of health, explaining health-seeking behavior, studying doctor-patient dynamics, facilitating culturally sensitive care, designing effective public health programs, and analyzing hospitals as social institutions.

Q2 & Q3. Meaning, Nature, Scope and Development of Medical Sociology & Medical Anthropology

Medical Sociology:

Studies the relationship between social structures, processes, and health/illness/healthcare.
Nature: Empirical, interdisciplinary, examines both sociology "of" and "in" medicine.
Scope: Social epidemiology, illness behavior, doctor-patient interaction, health inequalities, medicalization, health care systems and policies.
Development: Coined 1894 (McIntire) → Parsons' sick role (1951) → Black Report (1980) → global health and chronic illness focus today.

Medical Anthropology:

Studies how health, illness, and healing are culturally defined and managed across societies.
Nature: Holistic, qualitative/quantitative, culturally relative.
Scope: Ethnomedicine, explanatory models, ritual healing, mental illness, nutrition, reproductive health, applied global health.
Development: Rivers (1924) → Paul (1955) → Scotch coined term (1963) → Society for Medical Anthropology (1968) → critical and applied anthropology today.

SECTION 2: Comparison, History, and Stratification

Q. Similarities and differences between Medical Sociology and Medical Anthropology

Aspect	Medical Sociology	Medical Anthropology
Origin	Sociology	Anthropology
Primary focus	Social structures, inequalities	Cultural beliefs, indigenous medicine
Methods	Often quantitative + qualitative	Predominantly ethnographic
Unit of analysis	Classes, institutions	Culture, community, kinship
Health systems	Mainly biomedical	Both formal and traditional

Similarities: Both study health-illness from a social/cultural lens; both use qualitative methods; both are interdisciplinary; both address health inequalities and health-seeking behavior.

Q. Historical development of society and health system

Pre-literate/Hunter-gatherer: Shamanism, personalistic medicine, supernatural explanations.
Ancient/Agricultural: Ayurveda, Unani, TCM; Hippocrates introduced naturalistic medicine; Roman public sanitation.
Medieval: Church-run hospitals; Islamic scholars preserved Greek knowledge; Black Death prompted quarantine.
Renaissance/Early Modern: Scientific revolution (Vesalius, Harvey); Fracastoro's germ seeds (1546); social medicine (Virchow).
Industrial (19th c.): Sanitary movement (Chadwick); Pasteur/Koch germ theory; formal nursing; state public health.
Modern (20th-21st c.): National health systems; WHO (1948); Alma Ata/PHC (1978); SDGs; NCD transition.

Q. Health care delivery is closely related to social stratification - how and why?

Higher strata have better access (private care, specialists); lower strata rely on underfunded public facilities or forgo care.
"Social gradient of health" - health improves at every step up the social ladder.
Mechanisms: material (poverty limits purchasing power), psychosocial (chronic stress from low status), behavioral (circumstances shape risky behaviors), structural (health systems designed for dominant groups).
In Nepal: caste discrimination, rural-urban divide, and gender hierarchy are key stratification factors affecting care access.

SECTION 3: Short Notes

Topic	Key Points
Social Status & Role	Status = position in society (ascribed/achieved/master). Role = expected behaviors attached to status. Parsons' sick role: exempt from duties, not blamed, must seek care. Relevant to power dynamics in clinical settings.
Customs	Traditional shared practices (folkways, mores, taboos). Health relevance: food customs, childbirth customs (home delivery), menstruation taboos (Chhaupadi), funeral practices affecting disease spread.
Social Stratification	Hierarchical ranking by caste, class, gender, ethnicity. Weber's triad: class/status/power. Lower strata = more infectious disease, malnutrition; upper strata = more NCDs. Dalits face structural barriers in Nepal.
Personalistic vs. Naturalistic Medical System	Personalistic: disease from supernatural agents (spirits, sorcery) - treated by shamans (dhami-jhankri). Naturalistic: disease from natural imbalance (Ayurveda, humoral theory) - treated by restoring balance. Nepal uses both.
Cultural Relativism	Judge beliefs within their own cultural context (Boas). Opposite of ethnocentrism. Improves cultural sensitivity in health care; has limits where practices cause clear harm.
Ethnocentrism	Judging other cultures by your own standards (Sumner, 1906). In health: dismissing traditional medicine, labeling patients non-compliant. Causes distrust, reduces utilization, worsens disparities.
Ethnomedicine	Study/practice of traditional healing systems. Includes disease theory, healing rituals, practitioners (dhami-jhankri, vaidya, amchi), and medicinal plants. First resort for much of rural Nepal; WHO promotes integration.
Self-Medication	Use of medicines without professional supervision (OTC, prescription, traditional). Risks: wrong diagnosis, antibiotic resistance, drug interactions, delayed diagnosis. Common in Nepal due to poverty, distance, low health literacy, unregulated pharmacies.
Acculturation & Assimilation	Acculturation = partial adoption of another culture. Assimilation = full absorption. "Healthy immigrant effect" declines with acculturation. Acculturative stress causes anxiety/depression. Urban migration in Nepal drives dietary changes and NCD risk.
Cultural Shock	Disorientation when exposed to a foreign culture (Oberg, 1960). Four stages: Honeymoon → Frustration → Adjustment → Adaptation. Mental health risk for migrants, health workers in unfamiliar settings.

SECTION 4: Culture, Socialization, Socioeconomic Status

Q. Socio-economic status and under-five nutritional/health status SES affects child health through food security, maternal health, access to care, WASH, parental education, and health literacy. In Nepal, stunting/wasting rates are highest in the poorest wealth quintile and in Karnali/Sudurpaschim provinces. Interventions: conditional cash transfers, free child health services, nutrition programs, female literacy.

Q. Socialization and health care seeking behaviour Socialization through family, peers, religion, community, and media shapes health beliefs and care-seeking patterns. Issues: gender socialization (men delay care), religious socialization (divine fate), stigma (TB, HIV, mental illness), patriarchal authority over health decisions. FCHVs in Nepal act as agents of re-socialization toward modern health norms.

Q. Role of cultural factors in health seeking behaviour (especially in Nepal) Culture shapes illness explanatory models, lay referral systems, trust in healers (dhami-jhankri vs. doctors), dietary taboos during illness, purity/pollution beliefs, gender restrictions, childbirth preferences (TBAs), and mental health attribution (spirit possession). Delayed presentation due to cultural barriers worsens outcomes for TB, obstetric emergencies, and cancer.

Q. Socio-cultural determinants of health Social: SES, education, occupation, social support, exclusion, governance, environment. Cultural: illness beliefs, norms/values, religion, traditional practices, language, family structure, health literacy.

SECTION 5: Culture, Beliefs, and Nepali Health Practices

Q. Culture and its impact on health/disease Culture (Tylor, 1871) = shared, learned, transmitted, dynamic system of beliefs and practices. Impacts: disease causation beliefs, health behaviors (diet, hygiene, sexuality), illness expression, treatment compliance, stigma, social support. Cultural competence improves care quality.

Q. Health care practices prevalent in Nepal Nepal has a pluralistic system: (1) Biomedical - government HPs/PHCCs/hospitals; (2) Ayurvedic - government-supported, Tridosha theory; (3) Dhami-Jhankri - shamanic, spirit-based healing; (4) Homeopathy/Unani/Amchi; (5) Traditional Birth Attendants (Sudeni); (6) Faith healing/pilgrimage; (7) Home remedies/herbal medicine (700+ medicinal plant species).

Q. How belief systems impact access to health care

Supernatural illness beliefs delay biomedical care-seeking.
Health fatalism ("God's will") reduces preventive service uptake.
Religious objections to vaccines, blood transfusions.
Distrust of hospitals ("places to die").
Mental illness attributed to karma/possession prevents psychiatric help.
Humoral beliefs affect medication adherence.
Strategies: Engage religious leaders, use culturally framed health messaging, train health workers in cultural competence, involve community in program design.

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