Table 3

Representative quotes from focus-groups and interviews

Quote

Respondent

Country


A. Perceptions and knowledge of diarrheal disease


"The problem of diarrhea is quite serious; it has to do with hygiene habits especially, and with dietary habits."

MOH Official

Nicaragua

"It is not an important health problem because of low-mortality rate. Parents would seek early medical consultation. Most cases are mild diarrhea."

Community Health Nurse

Thailand

"Lack of knowledge regarding sanitation and hygiene, and myths and beliefs among rural populations about diarrhea leads to seriousness of the cases."

Public Health Care Provider

India

"It is a social problem and depends on water supply, and personal nutrition and hygiene."

Medical School Professor

Ukraine

"Due to negligence, people do not react immediately to the symptoms of the disease."

District-level private health care provider

India


B. Knowledge of rotavirus and rotavirus vaccines


"We don't know what the rotavirus is."

Nurse

Ukraine

". . .Maybe a little [knowledge of rotavirus] . . . I only know that it causes diarrhea."

General practitioner

Thailand

"Rotavirus is prevailing in western countries only. Diagnosis for rotavirus is not done in India. Not aware of vaccine."

State level health advisor

India

"It is a water borne disease. But one does not know about its prevalence in India."

Public health provider

India

"Not yet, not yet. I have not been informed about rotavirus diarrhea or the vaccine."

Policy maker

Indonesia


C. Other causes of diarrheal disease


"We know that viruses are the main cause of diarrhea, but don't know which."

Pediatrician

Ukraine

"The causes of diarrhea are mostly food-borne infections, both bacterial and viruses. Most of our cases are viral."

General practitioner

Thailand

"Eating mutton and chicken, eating food without washing hands, and living in unclean surroundings are causes of diarrhea."

Private Health Care Provider

India


D. Prevention of Diarrheal Disease


"Invest in campaign programs, especially during the peak season of diarrhea. Collaborate with community health centers focusing on hand washing, clean and safe food."

Advisor, Ministry of Health

Thailand

"Dispose dust and garbage on day to day basis. Dispose of infant stools properly and wash hands."

Village-level Public Health Provider

India

"In order to prevent diarrhea: exclusive breastfeeding."

Ministry of Health official

Nicaragua

"In previous times we had a lot of printing materials and posters regarding prevention of diarrheal disease and personal hygiene, now we don't have these."

Pharmacist

Ukraine


E. Diarrheal Disease Treatment


"Oral rehydration therapy is the best."

Ministry of Health Official

Nicaragua

"Most physicians don't even realize that decrease in death rates among infants in the past few years is due to broader implementation of rehydration therapy."

Medical School Professor

Ukraine

"The challenges [for treatment]: the culture of each individual, self medication, many purge their children and they come in dehydrated, they stop giving them food because they say it hurts them."

Private physician

Nicaragua

"Mothers stop breast feeding the child with diarrhea. This leads to seriousness." Public Health care provider, Village level, Indian

Village Level Public Health Care Provider

India

"People frequently use self-treatment with antibiotics, and this is bad."

Pediatrician

Ukraine


F. Zinc treatment


"Do not know much [about zinc]. It is still under study."

District-Level Public Health Care Provider

India

"We have never heard about zinc but think that regular use of yogurts can protect from gastroenteritis."

Pediatrician

Ukraine


Simpson et al. BMC Public Health 2007 7:281   doi:10.1186/1471-2458-7-281

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