Childhood diarrhoea and its prevention in Nicaragua

This study, based on the rural municipality of Villa Carlos Fonseca in the department of Managua, Nicaragua, describes a programme of diarrhoeal disease research, begun in 1986, and the use of its results in health promotion programmes. Chapter 1 introduces the investigations of diarrhoea, water supplies, sanitation, hygiene and health beliefs, and also the study site. Chapter 2 outlines infant morbidity and mortality in developing countries and gives specific information on diarrhoeal diseases. Chapter 3 contains a literature review of the health impact of improved water supplies / sanitation and hygiene on the incidence of diarrhoeal disease. The water supplies / sanitation / hygiene and health beliefs studies performed in Villa Carlos Fonseca are presented in chapter 4 along with a follow-up study to investigate the relation between mother's education, the different hygiene practices and diarrhoeal diseases. The results of an ethnographic study of traditional health beliefs and practices to determine the importance of local beliefs on the management of cases of diarrhoea are also included. A literature study in chapter 5 is used to identify which interventions are most likely to reduce faecal contamination of wells, waterholes and surface water. Since the rope-pump has become an efficient technology for use in the hand-dug wells common in Villa Carlos Fonseca and other rural areas of Nicaragua, a study to investigate the effect of rope-pumps on the microbiological quality of water and on the quantity of water used by households is described in chapter 6. The final chapter discusses the relevance of the Villa Carlos Fonseca studies.