Caretakers’ Management of Childhood Acute Respiratory Infections and the Use of Antibiotics, Bohol, the Philippines

This article describes the results of a qualitative research study which investigated the diagnosis and management of childhood acute respiratory infections (ARI) by their usual caretakers. Data are drawn from in-depth interviews with caretakers and health professionals, from observations conducted within the pediatric outpatient department and the pediatric ward, and from case-studies of sick infants. Caretakers -mothers and grandmothers - take advantage of a wide variety of health care options including home-based, traditional and biomedical, the majority obtaining treatment from different medical systems for the same episode. Resort to traditional therapeutic practice may precede or follow resort to biomedical care or home use of western pharmaceuticals. The study indicated women's compliance with medical prescriptions tended to be incomplete because of limited financial resources, fear of overmedication, or inappropriate emphasis on drugs prescribed for symptomatic relief. Overuse of antibiotics and other pharmaceuticals was also common. The study draws attention to the difficulty that programs for the control of ARI have in promoting antibiotics for severe illness while restricting their use. It draws attention too to discrepancies among program manager's, doctor's, and caretaker's definitions of severe illness, and the implications of this in the household management of ARI.