Abstract

PIP: This letter report on an extension of a study conducted in Simla hills India which seeks to identify maternal beliefs and attitudes concerning diarrheal disease. The respondents are predominantly rural or periurban, illiterate slum mothers who were interviewed by a doctor according to a pretested, multiterm questionnaire. Preliminary observations, based on 600 cases, show that about 15% of the resondents do not understand the nature of diarrhea, although most such mothers admit to seeking hospital advice regarding a child's bowel ailment. Almost 1/2 blame diarrhea and the associated pain and irritability on teething as well as heat, cold, rains, worms, and faulty feeding of the mother if the infant is breastfed. About 10% of the mothers try witchcraft before seeking medical advice. Milk, routine feeds, and fluids are believed to aggravate diarrhea by certain numbers of the mothers. However, many believe that highly diluted milk is useful in addition to gruel or dal (a lentil). Almost 1/2 restrict the food or fluid intake of children with diarrhea, and some stop breastfeeding. Some 30% gave children home remedies. About 25% are aware of oral rehydration therapy, but only 1/2 are convinced of the value and few know how to prepare the solution properly. More studies in various segments of developing country populations on how to counter ignorance of ORT need to be done. Also there is a need for a result-oriented health education strategy flexible enough to adapt to different situations. A multi-media approach is the best way of informing, changing behavior, and motivating people, but such programs are felt to be too expensive for developing countries. Alternative approaches need to be evaluated.