An intercultural comparison of home case management of acute diarrhea in Mexico: implications for program planners.

BACKGROUND

The objective was to assess the extent to which similarities in cultural beliefs and practices related to home management of diarrhea would permit general recommendations to improve the content of health care messages.

METHODS

We studied six communities in Mexico, covering rural and urban conditions, different ethnic groups, and different socioeconomic levels. Systematic data collection relied on open-ended, face-to-face interviews with mothers of children under 5 years of age who had had an episode of diarrhea. Similarities among communities were assessed by means of a quadratic assignment procedure applied to signs, symptoms, and treatment matrices. Significant similarity among most of the communities sustained use of a global composite matrix to represent all communities.

RESULTS

We suggest specific recommendations to promote sound home management of diarrhea based on significant correlations among signs and symptoms with treatments. Signs and symptoms include those promoted by the National Program for the Control of Diarrheal Diseases (diarrhea, fever, vomiting) and others commonly mentioned by mothers (stomach ache, sadness, restlessness, refusal to eat). Similarly, recommendations to use home-based treatments based on beliefs related to their use may include the feeding of rice water, soups, and broth to a child who is sad, or rice-gruel and teas for a child with a fever.

CONCLUSIONS

Our study supports that there are enough similarities among mothers' beliefs and practices for the care of acute diarrhea in childhood to support general recommendations at the program level.