THE CULTURAL CONSTRUCTION OF CHILDHOOD DIARRHEA IN RURAL NICARAGUA - RELEVANCE FOR EPIDEMIOLOGY AND HEALTH PROMOTION

As a component of a series of studies of childhood diarrhoea in rural Nicaragua, lay knowledge regarding the condition and its appropriate m anagement has been investigated through semistructured interviews with 70 mothers. These data have been combined with information from focus group discussions and observations from investigators who have been r esident in the study area for many years. For any episode of childhood diarrhoea, the lay nosology influences the treatment path followed. T hus for some types of diarrhoea, treatment at a health centre or healt h post and the use of rehydration fluids is seen to be appropriate, wh ile for other types the use of traditional healers or home-based treat ment, often explicitly without the use of rehydration fluids, is appli cable. The implications of lay nosological systems for the interpretat ion of epidemiological studies and for the implementation of health pr omotion programmes are discussed.