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 woul d permit general recommendations to improve the content of health care mess ages. Methods: We studied six communities in Mexico, covering rural and urban con ditions, different ethnic groups, and different socioeconomic levels, Syste matic data collection relied on open-ended, face-to-face interviews with mo thers of children under 5 years of age who had had an episode of diarrhea, Similarities among communities were assessed by means of a quadratic assign ment procedure applied to signs, symptoms, and treatment matrices. Signific ant similarity among most of the communities sustained use of a global comp osite matrix to represent all communities, Results: We suggest specific recommendations to promote sound home manageme nt of diarrhea based on significant correlations among signs and symptoms w ith treatments, Signs and symptoms include those promoted by the National P rogram for the Control of Diarrheal Diseases (diarrhea, fever, vomiting) an d others commonly mentioned by mothers (stomachache, sadness, restlessness, refusal to eat), Similarly, recommendations to use home-based treatments b ased 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 mo thers' beliefs and practices for the care of acute diarrhea in childhood to support general recommendations at the program level.