Abstract
BackgroundPneumonia is a leading cause of childhood hospitalisation and child mortality in Africa. This study explores local interpretations of Acute Respiratory Infections (ARIs), focusing on caretakers of children under five in the context of hospital care seeking.MethodsThe study took place in Manhiça, southern Mozambique and used Focused Ethnographic Study tools (FES) including field exercises and interviews.ResultsUnderstandings of terms used to describe ARIs differed between caretakers and hospital staff. Children's sicknesses that hospital staff diagnosed as ARIs were interpreted by caretakers as intermittent "attacks" of xifuva, a permanent, inherent and incurable chest illness. Caretakers thought that it was possible to manage and treat the attacks, which were caused by immediate natural factors such as food or the weather, but not the underlying illness, which was seen as having more indirect and social causes. Explanations of illness could not be neatly separated into pluralistic categories, but were characterised by syncretism, with "lay" and "biomedical" terms and concepts intermingling in practical care-seeking interactions between caretakers and health staff.ConclusionsHealth promotion should take into account the syncretism involved in explanations of ARIs in the context of practical care seeking for children. In doing so, it should draw upon lay interpretations and terminologies in order to stress the importance of seeking hospital care for all xifuva-type illnesses as well as seeking care for any subsequent attacks of an already diagnosed xifuva. However, this should be undertaken with awareness that the meanings of the terms used in practical care-seeking interactions may change over time. Health communication about ARIs should therefore be ongoing and evidence-based, even if ARIs appear to be well understood.
Highlights
Pneumonia is a leading cause of childhood hospitalisation and child mortality in Africa
In Manhiça, a rural area in Southern Mozambique, malaria is responsible for almost half of all hospital admissions and up to 19% of all deaths among children admitted to hospital [1]
Other research indicated that caretakers do not clearly recognise the signs and symptoms of Acute Respiratory Infections (ARIs): fast breathing or chest indrawing may not be recognised, or may be wrongly attributed to fever rather than a respiratory infection [10,11,12,13]
Summary
Pneumonia is a leading cause of childhood hospitalisation and child mortality in Africa. This study explores local interpretations of Acute Respiratory Infections (ARIs), focusing on caretakers of children under five in the context of hospital care seeking. Pneumonia is diagnosed in up to 16% of children admitted to hospital and results in considerable mortality [2]. Other research indicated that caretakers do not clearly recognise the signs and symptoms of ARIs: fast breathing or chest indrawing may not be recognised, or may be wrongly attributed to fever rather than a respiratory infection [10,11,12,13]. Even if caretakers use biomedical terms to describe ARIs, their meanings may be different to biomedical definitions [13]
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