Abstract
A strategy to develop a programme for the fluid management of acute diarrhoea in childhood, based on culturally and medically sound home-based practices, is presented. The strategy outlined comprised a sequence of studies. The first was an ethnographic description of home practices in the study area, oriented to identify mothers’ beliefs and practices regarding fluid management during acute diarrhoeal episodes, with the aim of selecting one beverage that could be used as a rehydration solution. Once the beverage was selected, the second study consisted of a clinical trial to test the efficacy of this beverage, compared with standard oral rehydration salts (ORS), in rehydrating children with acute diarrhoea. Having proved the clinical efficacy of the beverage, the third study consisted of a public health intervention, in which the use of the homemade beverage was promoted with the specific intention of rehydrating diarrhoea-affected children. Characteristics of the acceptability, preparation, and use of the promoted beverage at the community level were compared with those of ORS. A distinct feature of the strategy outlined was the attempt to follow a “from-the-village” approach to tailor the intervention, taking into account the mothers’ beliefs and practices as well as medical criteria.