A rapid, focused ethnographic study was carried out in a rural area of West Java, Indonesia to identify local beliefs, perceptions, and practices surrounding acute respiratory infections (ARI) in infants and young children. The study incorporates key informant interviews, open-ended interviews, and structured data collection from fifty mothers of young children selected to represent the geographical settlement pattern in the area: structured interviews with biomedical and indigenous health care providers; and structured interviews with fifty mothers who sought health care for an infant or young child with a respiratory illness. The most commonly perceived cause for ARI in children was air entering the body through some type of chill, exposure to draft or breeze, or change of weather. When fever or difficult breathing was present, mothers tended to increase the number and diversity the types of medicines used. Mothers recognized difficult as well as rapid breathing, both being described as "difficult breathing." More concern was expressed about fever than about difficulty in breathing. Effective medical care was more likely to be delayed for infants than for older children; infants were also more likely to be taken to an indigenous healer as the first-choice provider. Infants were less likely to receive an effective drug regimen even if appropriate medication was prescribed, because mothers commonly take the drugs in order to deliver them to the infant through breast milk.
PIP: During January-March 1991 in Gabuswetan subdistrict, Regency of Indramayu, West Java in Indonesia, interviews were conducted with health care providers, mothers, men from the community, traditional healers, biomedical and indigenous health care providers, 17-42 year old mothers who came to the community health center with an infant or young child with an acute respiratory illness (ARI), and mothers from the subdistrict with a child younger than 5 years old. This rapid ethnographic assessment aimed to examine local beliefs, perceptions, and practices relating to ARIs in infants and toddlers. The people perceived naturalistic and supernatural causes to be responsible for ARIs in infants and young children. Air or wind entering the body through exposure to a draft, breeze, or change in weather was the most commonly perceived cause of ARI. Eating rough or scratchy foods, worms, and spraining of a child's muscles were believed to leave a child vulnerable to ghosts, causing serious illness or death in children. Mothers recognized cough, fever, and rapid and difficult breathing as signs and symptoms of ARI. They were more concerned about fever than difficult breathing. Infants (= or 12 months) were less likely to be taken for effective medical care outside of the home during an ARI episode than older children. They were more likely to be 1st taken to a traditional healer. They also were less likely to receive an effective drug regimen (i.e., antibiotics), because mothers, traditional healers, and drug sellers believed that the drugs were too strong and that the mothers should take the drugs instead to pass them on through the breast milk. These findings were similar to those of other studies of Javanese culture and were predictive of significant health outcomes.