Acute childhood diarrhoea and maternal time allocation in the northern central Sierra of Peru.

ABSTRACT

PIP: During the daytime in the rural village of Macashca in the Callejon de Huaylas, Peru, data collecters conducted 30 minute interval spot check observations on the activities of 45 children aged 4-36 months and their mothers/caretakers to examine the effect of acute childhood diarrhea episodes on the activities of the mothers/caretakers. The mothers/caretakers took more than 2 hours/day to prepare meals and 0.13 hours/day to collect fuel and water. Mothers were the caretakers for about 70% of all observations. Overall, time spent on child care duties increased only slightly during acute diarrhea episodes. It increased markedly for children aged 12-18 months, however (230 vs. 415 minutes/day; p = 0.006). When mothers perceived diarrhea to be severe, the amount of time spent in caretaker activities increased (72% vs. 62% during health; p = 0.1). Time spent on productive activities (e.g., gardening, food preparation, and work for wages) did not change greatly during acute diarrhea episodes. Possible explanations why mothers did not change their activity patterns during acute diarrhea episodes include: lack of flexibility to change their activity patterns; diarrhea may not be perceived as a threat; and lack of knowledge of, or access to, diarrheal treatments other than herbal tea. These findings demonstrate the need for public health specialists to consider the amount of time spent on child health technologies when designing health interventions. Realistic assessments of the practice and efficacy of traditional caretaker patterns during diarrheal episodes should be conducted to design feasible, culturally appropriate, effective case management programs.