title: A community perspective on changes in health related to diarrhea in northeastern Brazil.
abstract: BACKGROUND
  Diarrhea is a major cause of death in children in developing countries. However, in Brazil, diarrhea-related morbidity and mortality have declined over the past decades.
  
  
  OBJECTIVE
  To explore community perspectives in Brazil on changes in health related to diarrhea and factors that may have contributed to these changes.
  
  
  METHODS
  This qualitative study included 12 focus group sessions held with 50 mothers and 42 grandmothers in the state of Ceará.
  
  
  RESULTS
  Most grandmothers reported having lost at least one child to diarrhea, and all participants had witnessed children dying from diarrhea in the past. The participants saw a clear decline in diarrhea over the past 20 years. They felt that this was due to social, economic, and cultural progress. The participants also considered government-supported outreach programs very important for health improvement.
  
  
  CONCLUSIONS
  Knowledge of diarrhea and its causes in the community is broad, but many traditional beliefs about the illness still prevail. The Brazilian experience is an example of the critical effect that policies to promote income redistribution and universal access to education, health, water supply, and sanitation services may have on the reduction of undernutrition and diarrhea among children.
authors.affiliation: Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: Márcia Maria Tavares
authors.initials: MM
authors.lastname: Machado
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Lindsay
authors.forename: Gabriela Maia
authors.initials: GM
authors.lastname: Mota
authors.forename: Carlos André Moura
authors.initials: CA
authors.lastname: Arruda
authors.forename: João Joaquim Freitas
authors.initials: JJ
authors.lastname: do Amaral
authors.forename: Birger Carl
authors.initials: BC
authors.lastname: Forsberg
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003153:Community Health Services / Q000639:trends; D003906:Developing Countries; D003967:Diarrhea / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control; D005190:Family / Q000208:ethnology / Q000523:psychology; D005260:Female; D017144:Focus Groups; D019456:Health Transition; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D009313:National Health Programs / Q000639:trends; D012423:Rural Health / Q000208:ethnology