ORS and the treatment of childhood diarrhea in Managua, Nicaragua.

This paper discusses results from a study of the household management of childhood diarrhea in a poor, urban neighborhood of Managua, Nicaragua, carried out between February 1987 and April 1988. Eight key informants and a random sample of 109 mothers were interviewed. Appropriate use of ORS was not found to be a common feature of the household management of diarrhea despite health education efforts to change mothers' beliefs and practices, and the provision of oral rehydration solution (ORS) packets by state health facilities, pharmacies and informal drug vendors. Although mothers knew about dehydration and ORS, their explanatory models for diarrhea, as well as actual practices, reflected heavy reliance on self-prescribed pharmaceuticals and home remedies, while ORS use was associated with clinic attendance. These findings point to the difficulties inherent in changing people's explanatory models for illness and illness management, and the importance of understanding the context in which treatment options are assessed and utilized.