Soc Sci Med. 1988 ; 27(1): 75-85.
The household management of childhood diarrhea in rural north India.
Department of International Health, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD 21205.
An in-depth anthropological study of child diarrhea in 3 villages in rural North India investigated the variation in the household management of child diarrhea. Qualitative and quantitative methodologies were used to collect data on a series of variables, including maternal knowledge, beliefs, and practices during diarrhea, feeding and fluid intake during diarrhea, treatment choices, and knowledge and use of oral rehydration therapy (ORT). The results showed both positive and negative diarrhea management behaviors. Almost all mothers continued to breastfeed normally, and did not decrease fluids during diarrhea. A shift in the child's diet toward 'softer' and 'cooler' foods rather than the withholding of food was the norm. The use of anti-diarrheals was widespread. Acceptance and sustained use of ORT was found to be inversely related to an understanding of the function of ORT. Eighty-one percent of mothers who had previously used ORT but who do not plan to use it again were dissatisfied because it 'did not stop the diarrhea'. These mothers thought that ORT was a medicine that would cure the diarrhea. Therefore, in ORT interventions there is a need to explain that the function of ORT is to replace lost fluids, and not to stop the diarrhea. Anthropological research of household diarrhea management can provide important information that will result in improved intervention design. Messages that are meant to change behavior must be based upon the target group's perception.