Academic journal article Journal of Health Population and Nutrition

Treatment of Childhood Diarrhoea in Nigeria: Need for Adaptation of Health Policy and Programmes to Cultural Norms

Academic journal article Journal of Health Population and Nutrition

Treatment of Childhood Diarrhoea in Nigeria: Need for Adaptation of Health Policy and Programmes to Cultural Norms

Article excerpt


Most illnesses, including diarrhoea, receive home- or self-treatment first. Since this is a cultural practice in most communities, it is important to learn about the various ways by which illnesses are treated at home. Choice of treatment for diarrhoeal diseases in children usually depends on the perceived type of diarrhoea and its apparent cause and severity. For example, igbe eyin or 'teething stools' is not perceived by the Yorubas in southwest Nigeria as a disease, and is not treated unless there is accompanying vomiting and mucous in stools (1). The actual treatment given to children varies from place to place in Nigeria (2,3). Herbs, other indigenous remedies, antibiotics, and other drugs are widely used (2,4). Educational interventions that do not take these practices into consideration may account for the wide gap between knowledge and practice regarding optimal treatment for diarrhoea at home (5).

As part of a project to develop, test, implement, and evaluate an educational programme to modify behaviour for the prevention of diarrhoea, we conducted a series of group discussions and a prospective survey in a rural area of Oyo State in southwest Nigeria to document the pre-intervention patterns of treatment for diarrhoeal diseases in the community.


Study site

The Ona Ara Local Government Area (LGA) of Oyo State lies southeast of Ibadan, capital of Nigeria. It covers an area of about 330 sq km, and has a population of 122,387 (3). It has about 200 communities, all of which are rural, except one village-cluster (Olorunsogo/ Olunloyo) in the outskirts of Ibadan. Except two, all roads in the Ona Ara LGA are untarred, and some are often a little more than footpaths. Electricity and piped water supply are available in only 3 village-clusters: Badeku, Akanran, and Olunloyo/Olorunsogo. There are 4 government health centres in the Ona Ara LGA, one of which (Badeku) was used as an outreach station of the Institute of Child Health, College of Medicine, University of Ibadan until 1992. Private medical and traditional practitioners also provide healthcare to the various communities. Most men are farmers, while the women are both farmers and petty traders. The people are of Yoruba tribe.

Data collection

Data were collected through a qualitative method (using focus-group discussions) and a quantitative method (surveillance of diarrhoea in children aged less than 5 years and reported treatment of each episode).

Focus-group discussions: A series of focus-group discussions (FGD) were conducted during 26 July 1993-2 August 1993 with parents of children aged less than 5 years. The composition of the groups and the villages selected were as follows: (a) one group with male parents, (b) one group with female parents, and (c) 2 groups with male and female parents. No participants in group (a) and (b) were married to one another. The influential community leaders identified the participants of FGDs. The number of participants in each group ranged from 8 to 12. A trained facilitator and a note-taker conducted each FGD. All FGDs were also recorded on audio tape. The authors transcribed the tapes, and analyzed the transcripts and notes on the perceptions of diarrhoea and its treatment. The responses were summarized under 'male' and 'female' categories. The responses from mixed groups were included under these 2 categories, depending on whether the participant was a male or a female in the group that proffered the idea. Little difference was found in the responses between the groups, and the findings are, therefore, summarized together.

Surveillance of diarrhoea: A census of all households in the selected village-clusters was carried out in July 1993, and a household identification number (called ADDR household number) was allocated to each eligible household. An eligible household was defined as a household with at least one child who is aged less than 5 years at the time of the study. …

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