title: Greater years of maternal schooling and higher scores on academic achievement tests are independently associated with improved management of child diarrhea by rural Guatemalan mothers.
abstract: Appropriate home management can alleviate many of the consequences of diarrhea including malnutrition, impaired development, growth faltering, and mortality. Maternal cognitive ability, years of schooling, and acquired academic skills are hypothesized to improve child health by improving maternal child care practices, such as illness management. Using information collected longitudinally in 1996-1999 from 466 rural Guatemalan women with children <36 months, we examined the independent associations between maternal years of schooling, academic skills, and scores on the Raven's Progressive Matrices and an illness management index (IMI). Women scoring in the lowest and middle tertiles of academic skills scored lower on the IMI compared to women in the highest tertile (-0.24 [95% CI: -0.54, 0.07]; -0.30 [95% CI: -0.54, -0.06], respectively) independent of sociodemographic factors, schooling, and Raven's scores. Among mothers with less than 1 year of schooling, scoring in the lowest tertile on the Raven's Progressive Matrices compared to the highest was significantly associated with scoring one point lower on the IMI (-1.18 [95% CI: -2.20, -0.17]). Greater academic skills were independently associated with maternal care during episodes of infant diarrhea. Schooling of young girls and/or community based programs that provide women with academic skills such as literacy, numeracy and knowledge could potentially improve mothers' care giving practices.
authors.affiliation: Department of Anthropology, University of Toronto, 19 Russell Street, Toronto, ON, M5S 2S2, Canada. aimee.webb@utoronto.ca.
authors.forename: Aimee L
authors.initials: AL
authors.lastname: Webb
authors.affiliation: Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, 30322, USA.|Hubert Department of Global Health, The Rollins School of Public Health of Emory University, Atlanta, GA, 30322, USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Ramakrishnan
authors.affiliation: Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, 30322, USA.|Hubert Department of Global Health, The Rollins School of Public Health of Emory University, Atlanta, GA, 30322, USA.
authors.forename: Aryeh D
authors.initials: AD
authors.lastname: Stein
authors.affiliation: Department of Anthropology, University of Toronto, 19 Russell Street, Toronto, ON, M5S 2S2, Canada.|Hubert Department of Global Health, The Rollins School of Public Health of Emory University, Atlanta, GA, 30322, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Sellen
authors.affiliation: Department of Anthropology, University of Toronto, 19 Russell Street, Toronto, ON, M5S 2S2, Canada.
authors.forename: Moeza
authors.initials: M
authors.lastname: Merchant
authors.affiliation: Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, 30322, USA.|Hubert Department of Global Health, The Rollins School of Public Health of Emory University, Atlanta, GA, 30322, USA.
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000628:therapy*; D004522:Educational Status; D005260:Female; D005440:Fluid Therapy; D006166:Guatemala / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000193:education* / Q000523:psychology; D009483:Neuropsychological Tests; D012424:Rural Population; D012959:Socioeconomic Factors
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