Pneumonia perceptions and management : a focused ethnographic study in rural area of Lalitpur, Nepal

Abstract

Childhood pneumonia is one of the main reasons for childhood mortality in Nepal. In this study, local beliefs, perceptions and illness management in childhood pneumonia are explored. A focused ethnographic study was carried out in a rural area of Lalitpur district, Nepal. The study incorporates focus group discussion, in-depth interviews, and observation from twenty mothers of children under five and ten community health workers. Key informant interviews were also included with two traditional faith healers and two traditional birth attendants. The findings showed that mothers recognize the symptoms of pneumonia mainly as breathing problems like swa swa aaune (difficulty in breathing), ghyaar ghyaar hune (noisy breathing), chito chito sas pherne (fast breathing) and kokha hanne (chest indrawing) including lethargy, fever and general weakness. The main severity indicator was kokha hanne (chest indrawing) the breathing problem and fever. Mothers perceived exposure to cold ( chiso) to be the dominant cause of pneumonia. Generally the treatment starts on home level with home remedies and if the symptoms persist they further seek treatment either with traditional faith healer or biomedical treatment according to the mother's perception of severity. It was found that despite this belief in mothers seeking biomedical care for pneumonia was high. Most of the health workers were also familiar with the mothers' use of local terms for pneumonia. They were also aware of the mothers' use of home remedies and traditional faith healing. This study demonstrates understanding mothers' perceptions on pneumonia and illness management should be considered to encourage prompt and adequate care seeking.