ABSTRACT
Acute respiratory infections (ARI) are among the principal causes of childhood morbidity and mortality in Latin America. In Guatemala, pneumonia is the leading cause of death in young children and is responsible for approximately one-third of the outpatient visits to pediatric services. A large proportion of these deaths result from deficient management, attributable to a failure to recognize the first signs of pneumonia, the presence of barriers that impede immediate care-seeking, consultation with unsuitable providers, or inappropriate treatment recommendations. The purpose of this brief qualitative study was to investigate the perceptions and behaviors with respect to ARI of the residents of San Juan Comalapa, a Kaqchiquel community in the central highlands of Guatemala. Thirty-two mothers were interviewed in their homes to determine how they classified ARI and what signs and symptoms made them seek medical attention immediately. The results revealed that the mothers could recognize the presence of rapid breathing but not that of chest retraction (two important signs of pneumonia). When they sought care for the child, they usually went to physicians or other providers at health centers and occasionally at private clinics, but rarely did they seek care at an early stage of the illness, owing to poor accessibility of the services and underestimation of the severity of the symptoms. This conduct can be modified by education. The authors make recommendations aimed at improving verbal communication between health care providers and mothers
Las infecciones respiratorias agudas (IRA) figuran entre las principales causas de morbilidad y mortalidad infantiles en América Latina. En Guatemala, la neumonía es la primera causa de muerte en niños pequeños y ocasiona aproximadamente una tercera parte de las consultas ambulatorias a servicios pediátricos. Una buena proporción de estas muertes se deben a unmanejo deficiente, atribuible a la falta de reconocimiento de los primeros signos de neumonía, a la presencia de barreras que impiden una búsqueda inmediata de atención, a la consulta a proveedores inapropiados o a recomendaciones terapéuticas inadecuadas. El propósito de esta breve investigación cualitativa fue estudiar las percepciones y los comportamientos de los habitantes de San Juan Comalapa, comunidad kaqchiquel en el altiplano central de Guatemala, en lo que respecta a las IRA. Se entrevistó a 32 madres en su domicilio con el fin de determinar cómo clasificaban las IRA y qué signos y síntomas las hacían buscar atención inmediata. Los resultados revelaron que las madres sabían reconocer la presencia de respiración rápida, pero no de tiraje respiratorio (dos signos importantes de neumonía). Cuando buscaban atención, solían acudir a médicos u otros proveedores en centros de salud y ocasionalmente en consultorios privados, pero la búsqueda raras veces era oportuna debido a la poca accesibilidad de los servicios y a la subestimación de la gravedad de los síntomas. Esta conducta podría modificarse por medio de una intervención educativa. Al final se hacen recomendaciones orientadas a mejorar la comunicación verbal entre los proveedores de atención de salud y las madres
Subject(s)
Respiratory Tract Infections/diagnosis , Pneumonia/prevention & control , Epidemiological Monitoring , GuatemalaSubject(s)
Breast Feeding , Health Policy , Caribbean Region , Latin America , Legislation, Labor , Women, WorkingABSTRACT
Las infecciones respiratorias (IRA) constyituyen una cuarta a tercera parte de las muertes de la población infantil mundial, especialmente en niños menores de dos meses. La eficiencias de las estrategias de manejo de estos casos depende de la habilidad de las familias para reconocer los signos de neumonía y poder solicitar atención inmediata a proveedores de salud debidamente capacitados. Una proporción significativa de muertes por neumonía puede ser atribuída a un menejo deficiente en el hogar, incluyendo la falta de capacidad de las familias para reconocer los primeros signos de la neumonía, las barreras para una búsqueda inmediata de atención, la solicitud de atención a proveedores no apropiados y recomendaciones terapéuticas deficientes. El propósito de esta investigación cualitativas fue estudiar la semántica, las percepciones populares y los comportamientos de salaud respecto a las IRA en cuatro comunidades de Guatemala. Con base en la distribución linguística del país se seleccionaron cuatro comunidades representativas de los cuatro idiomas principales: San Juan Comalapa, Chimaltenango (kaqchikel), San Juan Chamelco, Alta Verapaz (q'eqchí), San Bartolo Aguas Calientes, Totonicapán (k'iché) y cuatro aldeas del departamento de El Progreso (español). Las percepciones y comportamentos de las familias tienen un impacto significativo en el manejo doméstico de las IRA y en la prevención de muertes por neumonía. Los comportamientos y percepciones de interés incluyen etiología, el reconocimiento e interpretación de signos y síntomas, el tratamiento casero y la búsqueda de atención con proveedores de salud.
Subject(s)
Humans , Child, Preschool , Infant, Newborn , Infant , Guatemala , Health Knowledge, Attitudes, Practice , Pneumonia , Respiratory Tract Infections , Rural Population , SemanticsSubject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Guatemala , Health Knowledge, Attitudes, Practice , Pneumonia , Respiratory Tract Infections , Rural Population , SemanticsSubject(s)
Humans , Child, Preschool , Infant , Child , Health Education , Pneumonia , Respiratory Tract InfectionsABSTRACT
Qualitative information was collected of 64 indigenous women in highland Guatemalan and 73 mestizo women throughout El Salvador via in-depth interviews and direct observations prior to the design of education/communication programs. Data were collected on beliefs, attitudes and values related to infant feeding in the first 24-36 months and on actual breastfeeding and weaning practices during health and illness. Findings on cultural factors were related to the infant feeding decisions of interviewed women and to patterns of breastfeeding initiation, exclusive breastfeeding, introduction of liquids and weaning foods into infants' diets. In both settings, despite important differences in cultural traditions, women hold very similar and strong beliefs, attitudes and values towards the qualities of breastmilk, breastfeeding, the nutritional needs of young children, and their own capacity of produce adequate quantities of milk of acceptable quality. These cultural factors color their interpretation of infant behaviors such as crying and influence their day-to-day decisions about infant feeding. Dominant in the resulting suboptimal feeding patterns is the almost complete absence of exclusive breastfeeding beyond the second month. These findings demostrate the persistence of cultural factors in infant feeding practices in the early months
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Breast Feeding , Health Knowledge, Attitudes, Practice , Infant Nutrition , Central America , El Salvador , GuatemalaSubject(s)
Breast Feeding , Legislation, Labor , Women, Working , Central America , Community ParticipationABSTRACT
Qualitative information was collected of 64 indigenous women in highland Guatemalan and 73 mestizo women throughout El Salvador via in-depth interviews and direct observations prior to the design of education/communication programs. Data were collected on beliefs, attitudes and values related to infant feeding in the first 24-36 months and on actual breastfeeding and weaning practices during health and illness. Findings on cultural factors were related to the infant feeding decisions of interviewed women and to patterns of breastfeeding initiation, exclusive breastfeeding, introduction of liquids and weaning foods into infants' diets. In both settings, despite important differences in cultural traditions, women hold very similar and strong beliefs, attitudes and values towards the qualities of breastmilk, breastfeeding, the nutritional needs of young children, and their own capacity of produce adequate quantities of milk of acceptable quality. These cultural factors color their interpretation of infant behaviors such as crying and influence their day-to-day decisions about infant feeding. Dominant in the resulting suboptimal feeding patterns is the almost complete absence of exclusive breastfeeding beyond the second month. These findings demostrate the persistence of cultural factors in infant feeding practices in the early months