Perceptions of childhood diarrhoea and its treatment in rural Zimbabwe

In the course of a study on the acceptability and feasibility of home-based oral rehydration therapy in rural Zimbabwe, information was collected on attitudes and beliefs about diarrhoea and on action taken in response to an episode of diarrhoea in a child. Diarrhoea was found to be a perceived threat at community and family level and numerous possible causes of diarrhoea were described which were assigned to two broad classes: (1) 'physical' causes, such as a polluted environment, diet and teething and (2) 'social and spiritual' causes such as those associated with a depressed fontanelle. These domains were not, however, mutually exclusive; 76% of the described episodes of diarrhoea were attributed to 'physical' causes, 15% to 'social and spiritual' causes and 8% to a combination of both. Reported utilization rates of the formal health services were unexpectedly high. In contrast, we recorded a low demand for indigenous herbalists (n'angas). Home management was common and comprised the administration of indigenous herbal remedies, of sugar and salt solutions, of over-the-counter drugs or of enemas. These remedies were given on their own or alongside the treatment prescribed by a health worker. A number of variables were examined to assess their influence on health-seeking behaviour: perceived cause and severity of the illness, socio-demographic characteristics of the respondent or child and accessibility of the health services.(ABSTRACT TRUNCATED AT 250 WORDS)