Health seeking behaviour and self-treatment for common childhood symptoms in rural Guatemala

This study was conducted in the Guatemalan highland department of Sacatepequez, in a sample of 146 rural women insured by the Social Security system. It examined their health care behaviour when their children presented common childhood symptoms such as diarrhoea, fever, cough and worms. The mothers generally sought help and treatment advice from an older woman in the family, and did so more often for diarrhoea (82%) and fever (64%) than for cough (43%) or worms (28%). Obtaining advice in a pharmacy or from a drug seller ranked second (range: 8%-38%, depending on the symptom), before the procurement of professional help at a medical service (range: 8%-23%). Traditional healers were hardly consulted (range: 0%-3%). In the case of self-treatment the women predominantly relied on Western drugs: around 80% in diarrhoea and fever, and above 50% in cough. Herbs and traditional external remedies were little used, except in cough (27% herbs) and worms (58% external remedies). None of the mothers reported ORS as home treatment for diarrhoea. Problems of geographical or financial accessibility could not explain the low utilisation of the Western health care system. The acceptability of public services, however, was poor. Largely because the Social Security clinic did not prescribe the "potent" modern drugs mothers preferred for the treatment of childhood symptoms--at least, not for uncomplicated illness episodes. Women hence turned to the--partially informal--private sector, which unabashedly responds to their demands. Clear away the discrepancy between the "rational" needs perceived by the official health sector and the demands of the population is one of the bigger challenges to health care planning in transitional communities such as the one studied.