Local knowledge and treatment of malaria in Agusan del Sur, The Philippines.

Information about local knowledge of malaria, its transmission, treatment and prevention were gathered at the outset of a Malaria Control Program in order to incorporate this information into community interventions. Data were collected using focus groups and indepth interviews with caretakers of children who had had a recent episode of malaria. These were supplemented as baseline data through a survey and the ongoing participation of researchers in the intervention. Local knowledge of malaria was influenced by clinical diagnosis and was based on the coexistence of signs of illness. People conventionally self-medicated or used herbs for symptomatic relief prior to seeking clinical diagnosis and treatment, with treatment delay influenced by the logistic difficulties within the region, direct and indirect costs associated with treatment seeking, and delays in the return of results once a blood film for diagnosis was made. People were familiar with mosquito control activities conducted by the Malaria Control Service and, as a result, most respondents associated malaria with mosquitos. However, the role of the mosquito as the sole vector, and the means by which malaria was transmitted, were not well appreciated.

Responding to cough: Boholano illness classification and resort to care in response to childhood ARI.

A qualitative study into the health seeking behaviour of caretakers in response to ARI in children under five years of age was conducted in the province of Bohol, the Philippines. The study was designed to compliment survey data generated from a long running ARI intervention project, specifically to explain behaviours identified as problematic by the project. Results indicate the importance of folk diagnosis as a basis for selection of first resort for care in the management of childhood ARI. A cultural category, piang, was identified as a major factor influencing health seeking behaviour and delay in consulting the biomedical system where serious ARI exists. In addition, caretakers' financial situation and social contacts are important in their decision to seek biomedical assistance and are often implicated in delay in presentation and acting upon referral to hospital.

Child care practices of mothers: implications for intervention in acute respiratory infections.

An epidemiological study of acute respiratory infection (ARI) in an urban community showed poor utilization of available health services. This prompted us to undertake this study to identify determinants of child care practices of mothers through a focus group discussion and survey of the knowledge, attitudes and practices of mothers. The results will form the basis of appropriate health education strategy geared towards control of ARI. They showed that, generally, the mothers were unable to recognize a severe infection. Poor diagnostic ability compounded by a limited knowledge of the appropriate management of varying types or degrees of ARI resulted in inappropriate action. Consequently, there was a high rate of self-medication and a low rate of health service utilization. In addition, there was low compliance with childhood immunizations. With these limitations in the mother's knowledge and practices, an education programme utilizing an informative print material was devised to upgrade the mother's ability to recognize signs of ARI and to improve her management of the condition.