title: Home Care of Children With Diarrhea in Bangui's Therapeutic Landscape (Central African Republic).
abstract: We explore how the therapeutic landscape of Bangui, capital of the Central African Republic, shaped and reflected caregivers' home care of childhood diarrhea. Using interviews, group discussions, and participant observation, we found that caregivers described several categories of diarrhea, but in practice, adopted an experimental approach to home diarrheal care. Many managed incertitude by initially dosing children with street medicines and herbal infusions; they delayed seeking professional medical care to avoid expenses, observed their children's symptoms, consulted social networks, and used therapeutic foods. The logics underpinning these practices emerged from caregivers' conviction that diarrhea necessitated medical therapy and restricted choices within Bangui's therapeutic landscape, a consequence of lengthy political economic crisis. This crisis impoverished Bangui populations, eroded formal health care, and sharpened religious differences, discouraging care seeking from traditional healers. Analyses of therapeutic landscapes illuminate why caregivers embraced specific practices and logics and should guide the elaboration of more effective public health interventions.
authors: Institut Pasteur, Paris, France tamara.giles-vernick@pasteur.fr.
authors: Tamara
authors: T
authors: Giles-Vernick
authors: Université de Bangui, Bangui, Central African Republic.
authors: Louis
authors: L
authors: Bainilago
authors: Université de Bangui, Bangui, Central African Republic.
authors: Moussa
authors: M
authors: Fofana
authors: Centre Pédiatrique, Bangui, Central African Republic.
authors: Petulla
authors: P
authors: Bata
authors: Institut Pasteur, Paris, France.
authors: Muriel
authors: M
authors: Vray
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002488:Central African Republic; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006296:Health Services; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D010290:Parents; D011369:Professional-Patient Relations; D055815:Young Adult
keywords: Africa, sub-Saharan; children, illness and disease; families, caregiving; infants; lay concepts and practices; uncertainty