Soc Sci Med. 1988 ; 27(11): 1277-86.

Causal reasoning and the treatment of diarrhoeal disease by mothers in Kenya.

Patel VL, Eisemon TO, Arocha JF.

Centre for Medical Education, Montreal, Quebec, Canada.

A study of reasoning about the cause and treatment of childhood diarrhoea by Maasai schooled and unschooled mothers was carried out in Kenya, using a method of analysis developed within cognitive psychology. A dramatic difference in the conceptual structures of mothers' reasoning about both the cause and treatment of diarrhoea was found between the unschooled and schooled group. The unschooled mothers' explanation of diarrhoea was in terms of illness, resulting from social and moral factors. The knowledge structures generated showed global coherence. The schooled mothers explained diarrhoea with a series of quasi-biomedical facts about the disease with little or no connections between facts. The role of understanding the underlying disease processes for learning in health education is discussed in the context of Kenyan culture.