This is especially so in transitional societies where traditional and modern medicine are employed with the choice of one or the other determined by changing belief systems. Geographic distance and associated costs also come into play. In some cultures, the traditional health belief system places responsibility and blame on women and imposes a system of social control over the adult female population. Changing health beliefs are less the result of the introduction of a new health philosophy than of the retreat of traditional beliefs under the impact of other societal factors embodied in the older health philosophy.¹³