Ethnographic studies of ARI in Bolivia and their use by the national ARI programme.

Acute respiratory infections (ARI) are responsible for one quarter to one third of all deaths in infants and young children, with most deaths being attributed to pneumonia. At present, few measures exist to prevent pneumonia. However, most pneumonia deaths can be averted by treatment with an appropriate antibiotic. The effectiveness of this strategy depends on families' ability to recognize the signs of pneumonia, and to promptly seek care from a trained health practitioner. In order for health workers to communicate effectively with families about how to care for children with ARI, what signs to watch for, and when to come back for care, they need to know how families perceive and respond to respiratory infections. The WHO ARI Programme has recently developed a research protocol for conducting ethnographic studies of community perceptions and practices related to ARI. The purpose of this protocol is describe communities' explanatory models for ARI, identify cultural and other factors that facilitate or constrain appropriate home care and careseeking for children with ARI, and make recommendations to national ARI programmes about how to develop effective communication activities. This paper reports on two studies conducted in Bolivia using the WHO/ARI Focused Ethnographic Study (FES) protocol, and describes the way in which the data were utilized by the national ARI programme.