1295.pdf
Media
- extracted text
-
lyRNFfaGMENT
Dlfl'RRlWFfi
Ripo^t
on
fitbtuclti
S&/y ^i; Tn DinN
T^u^enu
TN
oF ■ . < ■
ftuRfiL TNp'^
/<hc?w&^,
'pjiacliu .
. Qlc f9g£ ■
MARKET
'pcs^cu
HOME MANAGEMENT OF DIARRHOEA IN
RURAL INDIA
Report on a Knowledge, Attitudes and
Practices Study - Methodology
DECEMBER 1986
Prepared for UNITED NATIONS CHILDRENS FUND
By INDIAN MARKET RESEARCH BUREAU
DELHI
IHRB/Rl/BS/67020
Indian Market Research Bureau
CONTENTS
1
Background
1
2
Information collected
2
3
Considerations influencing
the research design
11
Research plab and sample
coverage
15
5
Methodology
21
6
Field operations
28
7
Analysis and reporting
30
4
APPENDICES
A
List of districts and villages
covered
8
All India district map oresenting
the covered states, regions and
districts
C
Field instruments
Indian Market Research Bureau
1
BACKGROUND
Child diarrhoea has been named ’’The Greatest
Killer”.
It is responsible for an estimated
1.5 million deaths annually among children
below five years in India.
Results of studies
conducted in different parts of the country
have revealed that children below five years,
on an average, suffer
between two to three
episodes of diarrhoea per year.
The total
number of episodes of child diarrhoea in India
have been estimated to be between 300
and 500
million per year.
Growth retardation and mortality are the two
main consequences of diarrhoea.
Mortality is
attributed primarily to loss of body fluids and
salts (dehydration) during diarrhoea.
A nece
ssary first step in the prevention of dehy
dration and therefore mortality is the early
replacement of lost fluids and electrolytes.
The efficacy of oral electrolyte solutions
has been proven in several developing countries.
'r
It is believed that around 90% of diarrhoeal
cases can’ be adequately treated by administering
home available and home made fluids; around 10%
cases need quicker replacement of water and
electrolytes which can be provided by pre-packaged
Indian Market Research Bureau
d ll
2
special salts such as Oral Rehydration Salt
solutions.
Only
(ORS)
1% of diarrhoeal cases require
IV drips in addition.
The Government of India has set itself a target of
reducing by 50% diarrhoea-related mortality by the
year 1990.
In order’ to assist the Government of
India in its programme, the UNITED NATIONS CHILDREN’S
FUND (UNICEF) are proposing a large-scale educational
and training programme.
The main objective of this
programme would be to promote oral rehydration and
correct feeding practices, among other things, to all
those involved in the management of child diarrhoea
viz mothers, health practitioners consulted by
mothers, frontline workers (village health guides,
anganwadi workers, trained dais)and medicine re
tailers (retail chemists/pharmacists). To develop
this programme, UNICEF wished to gain greater
insight into the existing knowledge, attitudes and
practices of all the groups involved in the manage
ment of child diarrhoea.
With this objective UNICEF
commissioned IMRB to carry out comprehensive research
on knowledge, attitudes and practices regarding
diarrhoea in rural India.
Prior to commissioning
research several meetings were convened to brief the
agency and
mitted.
discuss the research proposal sub
UNICEF sought the help of various experts
to evaluate the proposed research design.
After
the proposal was finalised and the study commissioned,
a training workshop was arranged, in which UNICEF
Indian Market Research Bureau
3
resource persons and IMRB personnel involved in the
project participated.
At this workshop IMRB personnel
were briefed by experts from the Ministry of Health,
Planning Commission, All India Institute of Medical
Sciences, (AIIMS) and UNICEF Consultants who were
experts in Medical Sciences
and Social Marketing.
The Joint Secretary in-charge of the Diarrhoeal
Disease Control Programme was also actively involved
in briefing the agency.
This workshop gave the IMRB personnel an opportunity
to understand the magnitude of the problems of
diarrhoeal disease in India and to clear any doubts
that they might have either on technical/medical
issues or with respect to survey methodology.
The
workshop lasted for over three days during which
video recordings of pilot group discussions and
interviews with health practitioners and medical
retailers (carried out prior to the conference) were
shown to participants.
These video recordings were
used during internal briefings to our field force.
At the end of the workshop a short quiz was adminis
tered to determine the extent of knowledge grasped
by the participants attending the conference.
It was after this workshop in October 1985 that IMRB
was given the final go ahead for launching the pro
ject.
As would be discussed in greater detail in
Indian Market Research Bureau
4
the following sections the proposed research design
comprised two phases
*
The first was a ‘qualitative’
phase followed by a quantitative phase.
The first
phase of the study has just been completed and this
document is one of the eighteen volumes of the
report on this phase.
This document outlines the
design and methodology of the study’s first phase.
The other 17 volumes cover the findings of each of
16 states and an all India summary.
Indian Market Research Bureau
5
2
INFORMATION COLLECTED
The subject areas about which information was
collected are listed separately for each of the
three main target groups covered by the study.
I
*1
2
Mothers (of children below five years old with
emphasis on very young children)
2.1.1
General
-
Terminology used for and classification of
various kinds of abnormal stools/loose motions.
—
Beliefs/perceptions about causes of diarrhoea,
particularly among children.
-
Description of the symptoms, and the different
stages which a child patient goes through
during an episode of diarrhoea; perceived
duration of one episode.
-
Recognition of dehydration as a consequence of
diarrhoea and its seriousness.
-
Other perceived ill-effects/serious consequences
of diarrhoea.
-
Beliefs/perceptions about causes of death from
diarrhoea
-
Attitudes towards prevention and cure; efforts
made, if any,
to prevent diarrhoea among chil
dren.
Indian Market Research Bureau
6
-
Role of other family members in the home manage
ment of diarrhoea (viz:
father, parents-in-law,
etc.)
2.1.2
Feeding practices
-
Feeding practices adopted by mothers during the
various stages of a diarrhoeal episode; whether
these differ by neonates and weaned and older
children.
-
Prevalant post-diarrhoea feeding practices.
-
Whether feeding practices are different between
I
normal feeding and during and after diarrhoea.
i
-
Beliefs about and attitudes towards various
foods and fluids, particularly milk/breastmilk.
r
.
2.1.3
Treatment
-
Steps taken from the onset (first day) of an
episode till its end,
to treat the child.
I
-
Beliefs and practices regarding the treatment
of neonates and weaned and older children.
■
)
-
Traditional home remedies administered to a
child during diarrhoea.
-
Liquids (e.g rice water, lassi) which are
available in the home and are administered.
■
I
Indian Market Research Bureau
7
-
Nature of aduice sought by the mothers.
-
Role of various ’influencers1 and their reco
mmendations i.e anganwadi workers, dais, village
health guides etc.
-
The stage, at which a health practitioner is
consulted.
-
Seliefs/perceptions about effectiveness of
home/medical treatment.
-
Criteria by which the effectiveness of any treat
ment is judged (e.g reduced stools, greater
activity).
2.1.4
Oral Rehydration Therapy
-
The amount of fluid administered during diarrhoea.
-
Attitudes towards perceived role of fluids admi
nistered during diarrhoea.
-
Availability of and perceptions regarding ingre
dients used in the preparation of the sugar and
salt solution (SSS) i.e sugar/’guv’
(jaggery)
salt, water etc.
-
Awareness of/views about sugar and salt solution
packaged ORS and other electrolytes.
Indian Market Research Bureau
8
2.2
Medical practitioners and frontline workers
2.2.1
General
-
Beliefs and perceptions about the causes of abnormal
stools, particularly about causes of diarrhoea among
young children.
-
Perceptions about the types of diarrhoeal diseases
and the seriousness with which each of them are
regarded.
-
Description of the symptoms, and the different
stages through which a child passes during the
episode,
-
the estimated duration of an episode.
Seriousness with which dehydration is regarded
vis-a-vis other symptoms and ill-effects of diarrhoea.
-
Attempts made at education of parents on preventive
measures, and treatment in the early stages.
2.2.2
Treatment
-
Identification of the person who usually brings the
child patient.
The stage of the episode at which
the patient is usually brought.
The information
sought by the practitioner.
-
The extent of delay, self-prescription and resor
ting to home remedies.
these remedies.
ness .
What are the nature of
Perceptions of their effective
9
-
The type of examination carried out .
The
treatment recommended/medicines prescribed.
-
Advice given to the patient about the future
course of the episode and the effects of the
medicines.
-
The nature of recommendation regarding intake
of food/liquids/nourishment including breast
fed infants.
2.213
Response to ORT
-
Level of existing knowledge of ORT and its
role during diarrhoea, awareness of SSS, ORS
and branded electrolytes.
-
Awareness of the positive role of home
available fluids.
-
Views on the’role of ORT in the treatment, and
its usefulness in prevention/cure of dehydration/diarrhoea; views on how long it is to be
used during any typical episode, expected
reactions
of the patient/parents to advice
recommending ORS.
Indian Market Research Bureau
10
2.3
Retail chemists/pharmacists
2.3.1
General
-
Incidence/frequency of parents/patients
asking advice or recommendations regarding treat
ment of diarrhoea.
-
Suggestions usually made by the chemists.
—
Beliefs about the causes and consequences of
diarrhoea, the importance attached to the
problem of dehydration, the possible causes
of diarrhoea deaths, particularly among
neonates.
-
Level of existing knowledge of ORT and beliefs
about its usefulness/effectiveness.
-
Perceptions about the ingredients used in the
preparation of Sugar Salt Solution (SSS).
Views on effectiveness of ORT i.e HAF, SSS,
ORS and branded electrolytes.
Extent to
which each, of these prescribed.
Indian Market Research Bureau
11
3
CONSIDERATIONS INFLUENCING THE RESEARCH DESIGN
Outlined below are certain issues which had a
bearing on the research design. •
3.1
Very little was known about knowledge, attitudes
and practices relating to the management of
diarrhoea in rural India.
The thrust of the
research, in the first instance, was to understand
the range and diversity of the knowledge, attitudes
and practices as they exist across the length
and breadth of the country.
This objective it was
considered would be best met by a study which was
<exploratory1 in its approach.
This in turn
suggested the need to use ’qualitative1
than ’quantitative’
rather
research techniques.
It was borne in mind, however, that the purpose
of such a study was to serve as the basis of
the development of a mammoth communications/
educational campaign upon which considerable
financial resources and manpower would be
expended.
Before such a campaign was developed
it was considered necessary to test many of the
hypotheses about and possible solutions to,
the
problems of diarrhoea management which would be
thrown up by the exploratory survey, on some
’quantitative’ basis.
Only if this was done
would it be possible to determine the extent to
Indian Markel Research Bureau
J
"
I
I
•
-
I
J
T
I
:
I
1
:
I
8
12
which ths knowledge, attitudes and reported practices,
x
I
identified in the exploratory phase of the survey, are
1 -
actually prevalent in different parts of the country.
8
9
I
This in turn would help identify the key issues that
would need to be tackled through the campaign and
the relative emphasis to be placed upon each.
We therefore recommended a research approach which
» -
would combine both qualitative and quantitative
fl
techniques.
I 1
1
*
was
The purpose of the qualitative phase
to explore the range of prevalent knowledge,
attitudes and practices with respect to diarrhoea
management and to generate hypotheses tor social
.
i
1 -X
1
marketing solutions.
The purpose of the quanti
tative phase was then to attempt at determining
I '■-
the extent to which these knowledge, attitudes and
1 >
*1 z
practices are prevalent, and to provide more clearcut directions for action.
*• z
1 1 X
>
j1 r
1 r
1 r
n ?
& '
*i
3.2
Various key target groups were identified for the
study.
—
These uere :
mothers of children aged less than five years
with emphasis on very young children
-
medical practitioners and frontline workers
retail chemists and pharmacists.
r '
>t '
Of these groups it was felt that mothers would
be the most important.
They were likely to be
Indian Market Research Bureau
13
more receptive to new ideas where the health of
their children was involved and were likely to be
leading agents of change
*
It was also felt that knowledge, attitudes and
practices with respect to the management of
diarrhoea are likely to be far more variable and
diverse across the country among mothers, than
among the other target groups.
This it was consi
dered would be due to the mothers’ lower level of
knowledge and training about this subject.
It was felt therefore, that greater emphasis should
be placed upon mothers in this study and that the
’quantitative1 phase discussed earlier be restricted
to mothers alone.
The design of the quantitative
phase was limited in scope owing to the time and
cost constraints indicated to us during the discu
ssions prior to the finalization of the research study.
3.3
For a country as diverse as India, an all-nation
study in totality was considered to be less meaning
ful than a study of its individual parts.
Know
ledge, attitudes and practices related to diarrhoea
were likely to vary across the country just as other
socio-economic and cultural indicators do.
Therefore
the study was designed in a manner that would
reflect the status of each of several distinct
regions which together make up India.
It is assumed
Indian Market Research Bureau
14
that within such regions knowledge, attitudes and
practices would not differ to the extent that they
would between regions.
The need, therefore, was to stratify .the country
into as many homogeneous strata as was possible. It
was felt that the conventional state-wise classi
fication (which is based more on political consi
derations) would not suffice.
We felt that an appro
priate level of stratification could be achieved by
dividing the country into socio-cultural regions.
Each of these regions would comprise several dis
tricts, and lie within one state or state group.
The external boundaries of the districts, socio
cultural regions and state were superimposable.
We recommended that India be divided into 35 socio
cultural regions.
The details of these 35 socio-cultural regions are
discussed in the next section : Research plan and
sample coverage.
Indian Market Research Bureau
>/■
15
4
RESEARCH PLAN AND SAMPLE COVERAGE
4.1
Research design
As discussed earlier in order to capture the
range and diversity the prevalent knowledge,
attitudes and practices a qualitative research
study was carried out.
Both the focus group
and in-depth interviewing techniques were used
depending on the target group as follows :
Target group
Technique
Mothers of children
upto 5 years
Focus groups
Health practitioners
including frontline
workers
Depth interviews
Retailers of medicines
i.e chemists/pharmacists
Depth interviews
The purpose of focus groups among mothers was
to
i/
provide a better understanding of mothers1
knowledge of, attitudes towards and pra
ctices relating to diarrhoea
ii/
generate hypotheses which the quantitative
study in Phase II would attempt to quantify
Indian Market Research Bureau
16
iii/
provide directions to the researchtrin developing
and structuring the questionnaire for the quan
titative study to follow.
Depth interviews among health practitioners and retail
outlets were carried out to gain an understanding of
the extent of their involvement in ihe home management
of diarrhoea as well as obtain an insight into their
knowledge, attitudes and practices.
4.2
Sample coverage
The proposed sample size per region for each of the 35
regions comprised the following :
i/
4 focus groups among mothers X 35 regions
= 140 focus groups
ii/
8 depth interviews among health practitioners
including frontline workers X 35 regions
=280 depth interviews
iii/
4 depth interviews among medicine retailers X
35 regions
= 140 depth interviews
However as a result of the many discussions between
UNICEF and I MRS during the finalizing of the research
design it was considered necessary to obtain informa
tion from mothers who were at the time of the fieldwork
Indian Market Research Bureau
17
looking after a child with diarrhoea.
A fourth group of
respondents were then included in the research design
specifically.
-
(
mothers whose children currently had diarrhoea; among these
mothers in each region 4 depth interviews and observations
were carried out.
These interviews are referred to as
’live’ diarrhoea interviews.
It was not always possible to find respondents for ’live1
diarrhoea interviews in a village.
The study, however did
include 61 mothers whose children had diarrhoea at the time
of the fieldwork.
The details of the sample size covered in a state/state
The regional divisions of the
group are presented below.
state/state group are also mentioned (Column of the table).
Sample size
State/state
oroup
Reqion
______ Mothers
*fG r-iG/iD LD
Health
practitioners
Total
ICDS
PHC
Re—
toilers
Total
NORTH ZONE
—
4
2
2
4
8
1
1
4
14
-
2
8
1.
Punjab
Punjab
4
2
3
7
2.
Haryana
Haryana
4
-
3
6
3.
Himachal Pradesh/3 & !<
HP/3K
4
1
2
4.
Rajasthan
. Maru Pra
desh
8
1
7
. Mewar
A
* EG - focus group cornpri sing 6-8 respondents
MG - Mini-group compri-sing
2-5 respondents
ID - Indepth interviews
LD - Live diarrhoea interviews
Indian Market Research Bureau
18
State/state
□roup_______
5.
Uttar
Pradesh
Region
Meithers
PIG/ID
*FG
. West UP
. East UP
°
Sample size
Health
Practitioners
ICDS
PHC
LD Total
7
16
Retailers
Total
4
o
EAST ZONE
6.
Bihar
. Mithila
Magadh
8
-
7
17
—
4
8
8
—
5
16
1
5
8
8
—
8
16
—
4
8
4
-
3
8
-
4
4
—
3
20
4
8
11
1
30
-
10
16
. Jharkhand
7.
*
Orissa
. Coastal
Orissa
. Hills &
Plateau
8.
W es t
Bengal
. Ganges
Del ta
. Darjeeling/
Dooars
9.
Assam
. Brahmapu tra
WEST ZONE
10.
Gujarat
. Kutch
12
. Saurashtra
. Gujarat
Plains
11.
Madhya
. Malwa
13
10
and/BagheIkhand
. Chatisgarb/
Gondwana
.
Dandakaranya *
* Dandakaranya is a region cutting across Orissa and Madhya Pradesh
houndries was covered under Madhya Pradesh
Indian Market Research Bureau
19
S tate/state
group
_
12. Maharas
htra
Region
Mothers
*FG mg/id LD
16
Kokan
-
Health
Practi tioners
PHC
I CDS
Total
Retailers
Total
1
28
3
8
13
—
22
—
6
12
• Desh
• Marathwada
• Vidharba
SOUTH ZONE
13. Andhra
Pradesh
• Telengana
16
• Coastal Andhra
• Rayalaseema
—
14. Karnataka • Kama taka
14
• Kanada
• Old Mysore &
Malnad
—
7
24
—
6
13
15. Kerala
8
-
2
15
-
4
6
9
—
2
9
—
3
9
144
14
61
256
11
71
136
• Malabar
♦ Kerala
costal plains
16. Tamilnadu
• Coromandel
Coast
• Kongunad &
Nilgiri
Total
Details of the districts selected within each region
and the villages covered in each district are given
as an appendix at the end of this volume.
Deviations from the proposed sample-
The number of focus groups and depth interviews pro
posed against those actually conducted are shown below :
Indian Market Research Bureau
i
i
20
j
I
Target group
Proposed
Achieved
Mothers
140 Focus groups
144 Focus groups
14 Mini groups/Depth
interviews
61 ’Live’ diarrhoea
interviews.
Health Practi
tioners/Frontline
Workers
Retail outlets
280 Depth
interviews
256 depth in terviews
140 Depth
interviews
136 depth interviews
Though the actual coverage among mothers has exceeded that
proposed by far (4 focus groups, 14 mini groups/in-depth
interviews and 61 live diarrhoea interviews), there is a total
shortfall of 24 among health practitioners and 4 among retailers
since we were unable to find the desired number of respon
dents in some districts.
Indian Market Research Bureau
21
I
5
METHODOLOGY
5.1
Selection of dis triet/villaqes
It was decided that one district
*
for each of the 35
**
would be selected
regions to be covered by the
qualitative research study.
The selected district, it
was decided, should be as representative as possible
of the region from which it was selected in terms of :
i.
extent of industrialization
ii.
agricultural affluence
iii.
types of communities residing
iv.
other characteristics of the district e.g
tourism in Rajasthan’s Mewar region, hilly
terrain in Himachal Pradesh and J & K region etc.
Further in a district two villages were covered.
As
per the 1981 Census, it is estimated that approximately
57% of the rural population resides in villages with a
population of below 2000, about 27% in villages with
population between 2000 and 5000 and remaining 16% in
villages with population above 5000.
Bearing this in
mind one of the selected villages within a district was
a large village with a population within the 3000 and
4000 population range and the second a smaller village
in the 1000 to 2000 population range.
In some districts
where there were very few villages in any one of the
population ranges, two from the same range were selected.
Refer to Appendix A for a list of districts covered,
by state/region
The socio-cultural regional division of India is
22
Larger and smaller villages were selected to reflect
differences, if any, in behaviour and attitudes between
the residents of the larger and smaller villages.
After the selection of districts the District Census
Handbooks (a Govt of India Census Publication) of
the relevant villages were consulted for the sele
ction of the villages. In all cases the villages were
pre-selected and substitutes were provided.
In case
the original selected village could 'not be located,
a village from the substitute list was selected.
The
villages were at least 50 km from any major urban
centre.
It was decided that the sample size to be covered in
a district/region would be equally divided between
the two selected villages.
This was by and large
possible in case of focus groups which were carried
out among mothers.
However in the case of depth
interviews amongst the other target groups, parti
cularly retailers, most interviews were carried out
in the nearby towns visited by the village population.
5.2
5.2.1
Respondent selection and recruitment
Mothers
Two focus groups were convened in each village. In a
few villages we were unable to conduct two groups and
therefore substituted by conducting depth interviews.
In some cases when there was time, more than the
stipulated, number of focus groups were carried out.
Indian Market Research Bureau
>TTTl X 11 1111II
In-depth interviews or mini groups comprising 2-4
Additional groups
respondents were also carried out.
and interviews were carried out to cover a broader
spectrum of the communities residing in the villages.
Groups were always carried out among different commu
nities residing in the villages.
Usually the two main
communities of the village were selected.
These
communities could be different in terms of their
religion e.g Hindu, Muslim or occupation e.g land
owning, non-land owning (agricultural labourers),
traders etc.
Care was taken to include mothers with
very young children in the focus groups.
In the case of ’live1
diarrhoea interviews that is
interviews with mothers of children who had diarrhoea
at the time of the interview, an observation of the
child was also carried out.
Both focus group and depth interview participants
were recruited by interviewers.
The discussion/inter —
view was then carried out by a moderator.
At the time
of recruitment or after the group/interview, certain
information about the participants was collected
<
<
*'> <
V ><
r )'
)
)
) ) ) ) ) >) ) ) ) ) ) ) ) ) ) )
23
dix Cl).
In-some cases e.g the region of Maru Pradesh
in Rajasthan,
this was not possible since mothers
(
(
■
(documented at the end of each state report as appen
planning purposes and would not allow any ’forms’
to
be filled with their names on them.
(
(
'(
(
(
(
C
(
(
(
feared the field team was collecting names for family
31TJ33
’
t
Indian Market Research Bureau
,11 ,1111111
24
2.2
*
5
Health Practitioners
Health practitioners including frontline workers
available in the village at the time of the visit
were interviewed.
In some cases e.g Haryana special
trips were taken to the nearby ICDS centres to include
anganwadi workers in the sample.
In many villages there were no health practitioners
In some cases the ANMs and other
to be found.
front
line workers who were supposed to be visiting the
village every day were not available.
Villagers
reported that these workers seldom visited the
village.
In case the required number of interviews
could not be carried out in the village, mothers were
asked which, practitioners were consulted when their
child
was unwell.
The location of these practi
tioners was then determined by the interviewers and
interviews were carried out among them.
Health practitioners who were consulted by mothers,
irrespective of qualification were interviewed.
The
range included ayurveds, nadivaids, ohjas (witch
doctors), PHC doctors, MBBS doctors both private and
Government, unqualified practitioners.
Frontline
workers such as village health guides, Auxiliary Nurse
Midwives (AIMMS) primarily health guides, village
level workers, anganwadi workers etc. were included
in the sample.
Indian Market Research Bureau
rrt r r m n w
25
5.2.3
Retail outlets
I
Retailers stocking medicines were selected on the
same basis as health practitioners i.e those who were
visited by the villagers.
Barring a few villages
most did not have any medicine retail' outlets.
Re
tailers interviewed were usually located in the towns
near the villages.
Indian Market Research Bureau
26
5•3
Field instruments
A total of six field instruments were developed;
each instrument and its purpose is briefly described
below.
Field instrument
Village obser
vation sheet
Purpose
.
collect village statistics such
as population, facilities (medical
etc.) available
.
record general observations e.g
dispersion of castes, water
sources etc.
ii/ Mothers recruit
ment sheet
establish eligibility for parti
cipation in focus groups
collect general information
about mothers recruited for
groups
v/
’Live’ diarrhoea
child observation
sheet
record observed condition of
the child at the time of the
interview
Focus group discu- .
ssion guide for
mo thers
instruments providing a check
list of questions that the
research study was required
to answer
Depth interview
guide for health
practitioners
it
Depth interview
guide for medicine
retailers
u
* All field instruments are provided at the end of this
volume as Appendix C.
Indian Market Research Bureau
lllU L L U U
27
The finalization of the field instruments was preceded by
a series of revisions which were based on pilot field
visits and subsequent discussions.
Before the entire
set of instruments was finalized a pilot visit was
carried out covering an entire district/region (Rampur
*
in West UP).
On the basis of this pilot study the
instruments were translated into Hindi.
Translation
of instruments into the other regional -languages were
made from the Hindi version of instruments after field
visits to the corresponding areas by each of IflRB’s
Zonal offices.
* Pilots were also carried out in districts of West UP
and Haryana; specifically Bulandshahr, Gurgaon
Muzzafarnagar and Baghpat.
Indian Market Research Bureau
28
6
FIELD OPERATIONS
6.1
Interviewing and moderation
Ail depth interviews and group discussions were mod
erated by specially trained personnel.
The field
team comprised of at least one group moderator and
two indepth interviewers.
As far as possible, focus
groups were moderated by IMRB research executives
specializing in qualitative research.
6.2
Training
All key IMRB personnel who were involved with the
project under-went an extensive and formal training
workshop organized by UNICEF.
Personnel from all four
Zonal offices of INRB from the research and field
departments were present.
The training was conducted
by UNICEF personnel and experts on the subject of
diarrhoea management invited by UNICEF.
The training covered relevant technical aspects of
diarrhoeal diseases and the Government of India’s
diarrhoea management programme.
The objectives of the
research study and what was expected from the study
were explained in detail.
t
All the presentations made during the three day work
shop were video recorded.
These video recordings as
well as the experience gained by the various pilot
studies carried out in Delhi went into the develop
ment of a training kit.
This kit was used for
Indian Market Research Bureau
29
training of personnel at various Zonal centres .
This training was imparted over a period of 2 to 4
days.
Apart from the training kit a field manual
was developed which each member carried to the
field and used as ready reference whenever the need
arose.
6-3
Field logistics
The four Zonal offices had the responsibility for
the fieldwork in the states/regions under each
Zone (refer Section 4.2 for states allocated to
each Zone).
In each of the selected districts, one
town nearest to the two villages was selected.
The
field team usually stayed in this town and visited
the village during the day.
The Zonal Field Con
trollers and the research executives visited many
of the centres covered by the study.
Indian Market Research Bureau
30
7
analysis and reporting
All taped interviews were transcribed verbatim and then
content analysed.
The findings of the study are pre
sented in sixteen state reports.
each report is the same.
The structure of
The report’s are divided
into five main segments followed by a set of appen
dices A through G.
The first section of each state report is a Summary
which is further divided into two sub-sections.
The
first sub-section presents the main findings and
second attempts to reconstruct the typical diarrhoeal
episodes known in that area.
The Summary is followed by the Introduction which
presents certain statistics of the state and profiles,
the regions), district(s) and villages covered
within the state.
The next three sections, following the Introduction
present the findings from the three target groups
covered by the study i.e Mothers, health practi
tioners/frontline workers and medicine retailers.
Each of these sections begins with a sub-section
which profiles the respondents covered by the study.
The set of seven appendices in each state report
present the following information.
Indian Market Research Bureau
{I lli
I
j
>
31
A
-
General statistics of population, industry
and agriculture of each of the districts
covered in the state (source Centre for
I
district
Monitoring the Indian Economy
x
i
profile documents)
B
-
Information about the villages collected
on the village observation sheet.
C
-
Background information about the three
target groups collected from them.
D
-
Glossary of local terms used in the dis
tricts) covered.
E
-
Lists of normal foods and preparations
given during diarrhoea to children by
mothers.
F
-
Medicines stocked and prescribed by health
practitioners and retailers.
G
-
Method of preparation of HAF, SSS and ORS
mentioned by the three target groups.
H
-
State map illustrating the location of the
district(s), towns and villages covered.
Apart from the sixteen volumes of the state reports,
is a volume on the all India summary of the
findings and this methodology volume.
At the end
of this volume are the following appendices.
Indian Market Research Bureau
C) /%)
32
A
-
List of towns and villages covered in each
state (region/district)
B
-
All India district map showing the districts
covered by the study
C
-
Field Instruments
.
C1 - Village observation sheet
.
C2 - Mothers recruitment sheet
•
C3 - ’Live’ diarrhoea child observation
sheet
.
C4 - Mothers focus group discussion guide
.
C5 - Health Practitioners depth interview
guide
.
C6 - Medicine retailers depth interview
guide
Indian Market Research Bureau
I
I
I
a
I
•
*
h
h
<:
**
■*>
r?
*
*
* *
*
*
s z
*
Ri
•I
■I
*H "*
*
s Z
•» z
i Z
w
12
> ;
*
*
**
'
1 Rl
D
n
1
5
i
*
*
APPENDICES
APPENDIX - A
LIST OF DISTRICTS AND VILLAGES COVERED
States (Groups)
Reqions
Districts
Villages
Size of
*
village
NORTH ZONE
1.
Punjab
Punjab
Bathinda
• Dharampura
• Rar
L
S
2.
Haryana
Haryana
Rohtak
• Barona
• Kherari
L
S
3.
Himachal Pradesh/D & K
HP/j & K
**
Solan
• Dhar-ke-Ber
♦ Kasauli/Garkhal
L
S
4.
Rajasthan
Flaru Pradesh
Churu
• Ghangoo
Dasasar
L
S
Chittaurgarh
• Singhpur
• Nilod
L
S
West UP
Sha hjahan
pur
V Gariya Rangin
• Akbaria
L
S
East UP
Barabanki
• Dadra
. Mehmudabad
L
S
Gaya
. Karuna
. Kalpa
L
S
Piewar
••
5.
Uttar Pra
desh
EAST ZONE
6.
Bihar
Mi thia/
Magadh
7.
*
Jarkhand
Oarkhand
Santhal
Parganas
• Rohini
• Tarabad
L
S
Orissa
Coastal
Orissa
Baleshwar
. Hirigaon
. Gandarda
L
S
Orissa Hills
& Plateau
Kalahandi
. Badapodagude
• Amatha
L
S
Villages with population between 3000 and 4000 (1_ - Large) and
those with population between 1000 and 2000 (S - Small) were
covered
Himachal Pradesh and Oammu and Kashmir are taken as one socio
cultural region
Indian Market Research Bureau
States (Groups)
8.
9.
West Bengal
Assam
Size of
*
villaqe
R eqion
Districts
Villages
Ganges Delta
Nadia
. Pashim Naopara
. Kalupura
L
Darjeeling/
•»
Dooars
Maida
. Pulbaria
. Nishchitapur
L
5
Bharamputra
Valley
Lakhimpur
. Joyhing Tea Estate
• Kharkatia
L
S
Kutch
Kutch
. Khavala
. Meghpar
L
S
Saurastra
Amreli
. Sarambhda
. Khijadia
L
S
Gujrat Plains
Panchmahals
. Rampur
. Darunia
L
S
Malwa
East Nimar
• Arud/Oaswadi
. Paladi
L
S
Bundelkhand/
Baghelkhand
Shivpuri
. Singhniwas
. Nohri Kalan
L
S
Chatisgarh/
Gondwana
Durg
• Chauki
. Lumora
L
S
Dandakarnya
Bastar
. Bastanar
. Bakel
L
S
Konkan
Ratnagiri
. Velas
• Tide
L
S
Desh
Solapur
. Tarapur
. Umbre/Badi
L
S
Marathwada
Nanded
. Bodhadi
• Lakhampur
WEST ZONE
10. Gujrat
11. Madhya
Pradesh
12. Maharashtra
••
Vidharba
Bhandara
• 3amb
. Palora
•
L
S
L
S
* This region lies half and half between Orissa
and Madhya Pradesh
Indian Market Research Bureau
States (Groups)
Regions
Districts
Villages
Size o
villaq
13. Andhra
Pradesh
T elegana
Medak
- Hotib
. Doppur
L
S
Coastal
Andhra
East
Godawari
. Yendipalli
• Fakiriddin
L
S
Rayalaseema
Anantpur
. Chola Samudarm
. Pydeti
L
5
Karnataka
Gulbarga
• Kadechur
. Kategra
L
5
Kanada
Bijapur
. Wadawadgi
. Kuppakaddi
L
S
. Haikal
. Bheemasmudra
L'
«
14. Karnataka
Old r/lysoret& Chitradurga
Malnad
15. Kerala
16. Tamil
Nadu
S
Nalabar
Palghat
. Kakkayur
Coyalmannam
L
S
Kerala
Coas tai
Plains
Alleppey
. Fluzukeer
. Molakaira
L
S
Coromandel
Coast
Ramanathanpuram
♦ Kaothiparei
• Poralacheri
L
S
Kongunad &
Nilgiri
Fladuri
. Appanoonthu
. Appipalayam
S
S
Indian Market Research Bureau
APPENDIX C1
VILLAGE OBSERVATION SHEET
Sto to ________ ________________________ _
Zone
Base town
Village
Names of team members : Supervisor
(D•
•
(2)(3)
Name of Sarpanch/headman __________ __________________
Status in villages
___________
Date
ASK VILLAGE HEADHAN OR ANY OTHER RESPONSIBLE PERSON
1 •
Castos Present and es Lima. Led percentage of each
(a)
What are the different castes/communities living in
this village ?
(b)
If there were 100 households in this village how
many would belong to each of these communities/
castes ?
*
Approx
% of
.Caste (a)
each (b)
•
Hindus
Brahmin/upper class
1
Land owning farmers
2
Nun-land owning fanners 3
•
Trader class/Oanias
4
Untouchables/llari.jans
5
Muslims
Land owning farmers
6
Non land owning farmers 7
Other occupations
8
•
Sweepers/Chamars
.
Others (SPECIFY):10
9
______________________________ 11
2•
Estimated No. of voters :
Number
In the last elections how many
voters did you have in this village?
Indian Market Research Bureau
2
Humber
3.
Estimated p o p u 1 atip n_ :
What would be the total population of
this village including women, children
and infants ?
4.
Hain crops :
Which are the main crops of this village ?
5.
Other crops :
Apart from the
,
, and
what are the other crops grown ?
6.
(crops mentioned)
1 would now like to know about the facilities that exist in
your village or near by, but Tor your village, do you have
? IF YES ASK How many ?
ASK FOR EACH OF THE FACILITIES LISTED BELOW
Ho
Yes
Cooperatives (artisans, diary
products etc.)
0
1
Schools for children
0
1
Schools for adults
u
1
Village heal th/anganwadi/
frontline workers
0
1
Electricity for agricul
ture/! rrigation
0
1
Electricity for lighting
0
1
Flour mill/Chakki
0
1
Radio Transmission/no. of
sets
0
1
Provision stores
0
1
sets
0
1
Medical stores
0
1
IF YES
Number
__________
TV Transmission/no. of
Indian Market Research Bureau
m m um m :
7.
.*
A
fl
A
f
t.
t
*
<
2‘
2
2
2
How much rain docs this village get during winter and
during the monsoon ? Does this area ever get floods ?
*
>
8.
* ..
•» .
■»
■n
1 2
£™?.y.911
Area prone
floods
1
2
3
4
123
4
Water sources :
Wells
1
1
1
Hand pumps
2
2
2
Tube wells
3
3
3
River
4
4
4
Pond
5
5
5
Are there any sources of water which some castes
cannot use ?
i ,;
“i
* .<
n
1
1 _•
I
IF /YES1 ASK
10.
Which castes cannot use which sources of water
(SPECIFY BELOW)
Q. 10
Q.9
Yes :
1
?
No
I
1
»
»
I >
11.
I
I '*
• '
e '
I
Very
little
What are the different types of drinking water sources
in this village and other sources ?
Tell me only about
the ones tho village people use, separately for agriculHow many of each of these arc thcr
torei and other uses.
for different iuses ?
AgriHome use
Drinking
culture
water
Type Ho
Type No
Type
No
A
>
None
~
Monsoons
'
2
,x
...
:
Winter
SI
*
*
T
T
’
ti
•>
Rain
i
•
I
•
i
l
1
:
2
Is there a market in the village or one that comes to
village ? How often in a week does this market come
to your village ?
Existence
v
n
o
Yes :
1
No : 2
No. of days in a week held
(SPECIFY)
-------------- L
4
Season
f ruits
12.
What are the different fruits
available in your village in
the different seasons ?
--------------------
13.
~
4i
.• on
i.
Vegetable
What are the different vegc----- 1-----------tables available in your village
in the different seasons
14.
Whare the cereals available
in your village
15.
Where do the village people
obtain salt from ?
16a.
What are the different types
of sugar do people of this
village use ?
16b.
Where do they obtain those
from ?
17.
Where do the village people dispose of their household
garbage ?
Where (b)
Type(a)
fledical type (a)
18a.
Number (b)
Who do village people go to
if their infants/children
fall ill ?/Tb11 me about all
the different types of medi
cal practitioners that is
■J-
veds/hakims /ojha’s (LIST
ALL TYPES)
18b
y
How many such practitioners
are there ? ASK BY TYPE
Indian Market Research Bureau
19.
From where do the vill-tie
people usually buy their
medicines ?
20a.
Where is the nearest agganwadi worker/primary health --------------------guide/field worker located
20b.
How often docs she come to
your village ?
21.
Where is the nearest hos
pital located ?
What arc the different types
of transport available to the
base town/othor villages ?
x
Hase
town
Other villages
ASK PRADHAN AND IIIEN UHblJh/E FOR YOURSELF
23a.
How many ’ktichha’ and how
many ’pucca1 houses are’
there in the village
No. of houses
Kuchha :
pucca
:
Othors(SPECIFY) ________
23b.
How many roads are there
coming to the village
23c.
Where arc the water sources
located in the village ?
23d.
How are the different castes
in the village dispersed ?
24.
RECORD NO. AND CONTENTS OF
ANY HOARDINGS OR WALL
PAINTINGS :
____
No. of roads
Indian Market Research Bureau
APPENDIX C2
R £■ CfII11HE N T QI IEST J ON N AI R E
Zone
State
Village
Recruiter’s Name
Base Town
Supervisor’s Name
Cato
Name of Respondent
Respondent’s Caste.
Name of Husband
Occupation of Husband
Live Diarrhoea
1
Group discussion
2
I have come from
(MENTION NEAREST TOWN).
I am doing
research work for a company called Indian Market Research
Bureau,
Th s research is being carried out in villages aJ1
over India to find out what village people do to cope with
illnesses and diseases among young children.
1.
How many people live in your household ?
No. of :
ADULTS
Joint family
_
Who are they ?
CHILDREN
_
Single unit family
«
2.
How many children (both boys and girls) do you have ?
3.
What are their ages ?
No• of childron
Male
Female
Upto 2 year
2-5 years
5+ yr
IF AT LEAST ONE CHILD BELOW
ONLY FOR CHILDREN < 5 YEARS
YEARS CONTINUE, ASK
Indian Market Research Bureau
2
4a
What illnesses or discomforts has
your 2 year old
child suffered so far ? DO NOT PHOHPT
b
And your 2-5 years old(s) ?
c
ASK FOP CODES 1, 2 & 3
When was the last time one of your children had an
attack ?
(SPECIFY)
d
Do any of them have
now ?
(a)
2 yrs)
■ (b)
2-5 yrs
Diarrhoea
1
CONTINUE
Dysentry
2
"
2
ii
Cholera
3
"
3
ii
Colds/coughs
4
4
Chicken pox
5
5
Pleasles
6
6
Pneumonia
7
7
8
8
9
9
(c)
RECORD WHEN
LAST EPISODE
(d)
CODE IF
CURRENT
1 CONTINUE
■»
Othsr(SPECIFY)
*
CONTINUE ONLY IF CHILD HAS DIARRHOEA.
IF THE CHILD
CURRENTLY HAS DIARRHOEA, THEN USE RESPONDENT FOR ’LIVE
DIARRHOEA’ INTERVIEW
’ "5a
What do you do, do you go out to work, or do you stay at
home to look after the house ?
b
IF GOES OUT ’ASK1 :
What work do you do ?
c
ASK-FOR EACH
How many hours in a day do you spend at this work ?
Indian Market Research Bureau
3
(□)
(c)
No. of hours (SPECIFY)
(b)
Stay at home
1 GO TO Q.7
Go out to work
2 CONTINUE
1
Work in the fields
Tend to care/feeding livestock 2
Others (SPECIFY)3
6.
7.
What do you usually do with your children, when you go to
work ?
Take all of them along
1
Take only younger children
along
2
Leave all behind with some
other adult
3
Leave all behind alone at
home
4
Other (SPECIFY)
5
I am asking others like yourself to come and tell me
something about how you copo and what all you do, when
your children fall sick. Will you come ?
Yes :
1
No
We are meeting- at
:
2
(PLACE) for about one hour.
IF ATTENDING, OBSERVE OR ASK AND RECORD :
Pucca 1; Kuchhg/Pucca 2; Kuchha 3
B.
a.
Type of house :
,
b.
No. of rooms (with a door):
c.
Drinking water obtained from (SPECIFY)
1
2
’ d.
Other water obtained from (SPECIFY)
e.
Type of container used to store :
Narrow neck
Wide/open mouth
3
5+
4
Drinking
water
Other
water
1
2
1
2
Indian Markci Research Bureau
111121
r
f.
Whether any livestock (buffalos, goats)
2
No :
g.
1
Yes :
1
Whether usually kept within living quarters :
1
»
separate :
h.
Where people usually go to the toilet ?
Latrine in house
:
1
Latrine near house
:
2
Open fields
:
3
Othors(SPECIFY)
i.
2
4
Where infants stools disposed of [SPECIF-Y)
Yes
No
*
J.
k.
1.
m.
Whether radio listed to by
household members
1
2
Whether TV viewed by household
members
1
2
Whether newspapers etc. looked
at by household members
1
2
No. of calendars/posters in
house :
None
:
0
One
:
1
Two+
:
2
Indian Market Research Bureau
b
j;
APPENDIX C3
LIVE DIARRHOEA CASE
OBSERVATION CUM INTERVIEW
Zone
State
Region
District
Base town
Village
Caste
Name of mother
Name of interviewer
Date
— — — — — — — — — — — — — — — — — — — -ik- — — - —
— — — — — -
Sex of child M/F
Age of child
(in years and months)
TERMINATE IF OLDER THAN
5 YEARS
My name is
I work for Indian Market Research
Bureau a company that carries out market surveys.
SELF
The company carries out market surveys in different
IMRB
parts of the country among all types of people.
These surveys are carried out to find out what
people feel about various things.
TOPIC
Currently our company is conducting research in
m$ny villages like this all over the country.
:
The survey is being carried out to find out
what village people do to cope with disease
and illness among small children.
QUESTIONNAIRE :1 will now like you to tell me about the illness
your child currently has. What ever you tell me
I will write on this paper since I will not
remember everything.
TAPE RECORDER:! may have to record our talk because I can’t
write all that we wi^l be saying.
to it and later onjwrite down.
ASK MOTHER
:
1.
For how many days has the child
had diarrhoea ?
2.
How many stools does the child
currently pass in a day ?
I will listen
SPECIFY DAYS/WEEKS/MQNTHS
NUMBER
Indian Market Research Bureau
2
OBSERVE AND ASK MOTHER
3.
APPEARANCE OF THE CHILD : DESCRIBE IN YOUR OWN WORDS AND
THEN ASK MOTHER TO DRAW A COMPARISON BETWEEN NORMAL AND
CURRENT APPEARANCE.
IF IT IS NOT POSSIBLE TO OBSERVE
FILL ONLY MOTHER’S RESPONSE.
OBSERVED
MOTHER’S RESPONSE
i/
Colour of skin
ii/
Texture of skin ’
iii/
State of .eyes
iu/
State of stomach
v/
Colour of stool
vi/
Consistency of stool
vii/
Amount passed at a time
__________
_______________
viii/
Colour of urine
_________
____________________
ix/
Amount of urine
_________
____________________
4.
ASK MOTHER : (a)
'
Is the child vomiting ?
IF YES How many
times a day ?
(b)
Does the child have favor ?
CODE IN GRID :
Yes
No
VOMITING
1
2
FEVER
1
2
No. of times/days
Indian Market Research Bureau
3
WATER CONTAINER
;
ASK MOTHER/lF POSSIBLE OBSERVE AFTER
YOU CAN SAY : Your definition
GETTING MOTHER’S RESPONSE.
of tho water container may be different from mine, could I
see the container to chock if what I have recorded is right ?
f ASK/OBSERVE BOTH DRINKING AND OTHER WATER CONTAINER.
—
DRINKING
IF ’BOILED’
OTHER
Narrow mouth
1
2
1
Open/largo mouth
3
4
2
DESCRIBE CONTAINER :
-
Where container placed
Where water obtained :
Location of water source
6.
PROCESS OF CLEANING CHILD :
6.1
MODE OF CLEANING FACES
:
(eg. cotton wool, cloth, water,
barehand) SPECIFY IF A COMBI
NATION OF MODES USED.
ASK : How do you clean the
child after he has passed
stools ?
6.2
STAINED CLOTHES : What do you
do with stained clothes ?
IF
WASHED ASK : Where do you wash
them ?
With what do you wash
them ?
IF THROWN AWAY ASK :
Where do you dispose the
stained clothes ?
Indian Market Research Bureau
4
6.3
WASHING OF HANDS :
How do you wash your hands
after cleaning the child ?
What do you use to wash
hands ?
6.4
NOW GO THROUGH THE GROUP DISCUSSION GUIDE, REFER ALL
QUESTIONS TO THE DIARRHOEA EPISODE.
USE TAPE RECORDER.
6.5
ATTACH THIS QUESTIONNAIRE TO RECRUITMENT QUESTIONNAIRE
OF THE SAME RESPONDENT.
Indian Market Research Bureau
APPENDIX C4
MOTHER'S GROUP
1.
DISCUSSION GUIDE
INTRODUCTION
1.1
Introduce self
Ply name is
......................... .. I work for Indian Market
Research Bureau a company which carries out market
surveys.
*
1.2
Introduce IMRB
The company carries out market surveys in different
parts of this country among all types of people.
These surveys are carried out to find out what
people feel about various things.
1.3
Explain topic
Currently our company is conducting research in
many villages like this all over the country.
The survey is being carried out to find out
—
what the village people do to cope with disease
and illness among small children.
1.4
Explain your position
I have always lived in a city so I know nothing
about villages.
You will have to tell me every
thing jrou know; this will help me in knowing
more about villages.
1.5
Explain GD guide
I have written down on this piece of paper all
that I want you to tell rne about.
1.6
Explain tape-recorder
I am sure we will have a lot to talk about and
discuss.
Since, it will not be possible for me
to write everything we discuss, I have this tape
recorder which will tape everything, later on I
will listen to it to remember all that v
Indian Market Research Bureau
1.7
I
1.8
There are no right or wrong answers.
I just want
to know about your experience and knowledge about
the ways of people living in this village.
ASK EACH RESPONDENT
:
What is your name ? How
many children, both boys and girls do you have ?
What are their ages ?
THE POINTS WHICH NEED SPECIAL PROBING/EMPHASIS
ARE MARKED WITH A *
2.
GENERAL QUESTIONS
2.1
What kind of work do you do ?
Do you go out of the
house to do work in the fields etc or do you do
only household work ?
2.2
How often do you go to
..... (NAME NEAREST TOWN)
or other towns ? And how often does your husband
go ? • What do you usually ^o to town for ? And
your husband ?
2.3
You said you have
(MENTION NO. OF CHILDREN).
Let us talk about the younger children (Who are
younger than 2 years and older than 3 months). What
are the foods that they eat and drink in a day on a
regular basis ?
2.4
Let us talk about your children, those who are
younger than 5(2) years and older than 3 months.
What are the foods that they eat and drink in a
day on a regular basis ?
2.5
How is the health of your children nowadays
What
illness have your children recently had ? What others ?
Are there some illnesses which occur only in some
seasons ?
What are they ?
IF DIARRHOEA/LOOSE STOOLS NOT .MEN!I0NED PROMPT LOOSE
STOOLS (DO NOT MENTION DIARRHOEA) WITH NAMES OF ANY
OTHER TWO ILLNESS NOT MENTIONED : SAY :
Indian Maikct Research Bureau
3
2.6
Do children ever get malaria (OR ANY OTHER
ILLNESS NOT MENTIONED), loose stools etc ?
2.7
Are there different types of diarrhoea/
loose stools ?
IF YES
What are they ?
What are the names of different types of
diarrhoea ? How are .they different ?
USE THIS GRID, TO MAKE SURE ALL ASPECTS ARE
COVERED.
LIST THE TYPES OF DIARRHOEA ON THE
LEFT AND TICK IN EACH OF THE COLUMNS AFTER
PROBE/QUESTION HAS BEEN COMPLETED.
T
Type/name of
diarrhoea/
loose motion
Cause(s)
Treatment
Food/drink
-------n6F
all
Allowed owed
1.
2.
3.
4.
5.
2.8
Which disease/illness including the different
types of diarrhoea, in your opinion, is most
serious ?
2.9
Which is the most serious among the types of
diarrhoea/which causes you the most concern ?
Why ?
OBTAIN A RANKING FOR ALL DISEASES/lLLNESSES
INCLUDING ALL TYPES OF DIARRHOEA.
Indian Market Research Bureau
4
3.
QUESTIONS RELATED TO DIARRHOEA
3.1
RECENT CASES OF DIARRHOEA
Have your children ever had diarrhoea ? When was
the last time your child had diarrhoea ? FIND
ABOUT THE CURRENT AND RECENT CASES OF DIARRHOEA.
3.2
CAUSES
You have told me about
and
types of diarrhoea.
Why do you
think a child gets diarrhoea ? What do you think
causes diarrhoea ?
Anything else ? Tell me
about each type of diarrhoea separately PROBE
AROUND :
3.3
3.4
-
Polluted food
-
Part of growing up
Seasonal changes
Germs
-
Unhygienic conditions
PREVENTION OF DIARRHOEA
3.3.1
Do you think it is possible to prevent
diarrhoea ? Why/Why not ?
IF ’YES
*
ASK : What are the things a mother
can do to prevent a child from getting
diarrhoea ? Do you do any of these
things ?
3.3.2
If a child has already had diarrhoea
what can be done to prevent the child
from getting diarrhoea again ?
SYMPTOMS AND CONSEQUENCES
3.4.1
What happens to a child soon after he
or she gets diarrhoea ? What are the
other signs ?
And later on, what effects
does diarrhoea have on the child ?
3.4.2
What is it about diarrhoea and its
symptdms that worry or bother you
most ? Why is it so ?
(ASK FOR EACH TYPE)
Indian Market Research Bureau
5
3.4.3
3.5
Now think of a child (5 years old) who has
never had diarrhoea.
How will this child
be different from another 5 year old who
has had it many times. (PROBE : Appearance,
General health, Appetite, Activity level)
LAST DIARRHOLA EPISODE
3.5.1
Thinking of the last time your child had
diarrhoea.
When was it ? How old was she/
he ? Was it a bop or girl ? What were the
first signs ? What happened next and next ?
How long did one (attack or episode last ?
What happened to the child during this time ?
IF THE RESPONDENT THINKS OF DIARRHOEA IN
STAGES.
a/
-
FOR EACH,STAGE ASK :
How was the child’s health/physical
appearance then ?
How was it diff
erent from before ?
b/
-
How was the child’s mood/behaviour then ?
Was was it different from before ?
c/
-
What type of stools was the child
passing then ?
(IN TERFIS OF COLOUR,
SMELL, CONSISTENCY).
How were they
different from before ?
d/
-
How many stools was the child passing
then ?
How many more than before ?
e/
-
What about urine ?
f/
-
What Goods did you give it to eat and
drink ? What else did you give ? How
do you prepare this ? With which
ingredients ?
g/
-
How many times in the last year has this
child had ^iarrhoea ? Do most of the
children here in the village have thses
number of jattacks, or do they have more
or less ? ,
Indian Market Research Bureau
6
3.5.2
Doos diarrhoea differ from child to
child ?
In what way ?
Does diarrhoea differ from episode
to episode ?
In what way ?
Doos diarrhoea differ from stage to
stage ?
In what way ?
PROBE AROUND
. Rs
health/apphysical appearance
mood/behaviour
number/type of stools
-
length/duration of each stage
~
amount/type of, urine
I
3.6
SERIOUSNESS OF DIARRHOEA
3.6.1
When does diarrhoea become serious ?
what stage ?
3.6.2
At
What,are the signs ?
What could happen, at worst, to the child
when it had diarrhoea '?
3.6.3
You mentioned ••••••••• could happen to
a child, how do you know this ? Have
you seen it happen ? When ?
USE SAME TERMINI LOGY FOR DEATH AS THE
RESPONDENT
3.6.4
Does this .... (USE SAME WORDS THAT THE
RESPONDENT USED WHEN ANSWERING 3.6.2)
happen to all cases of diarrhoea ? Why/
Why not ?
3.6.5
■■
What is the difference between cases where
...1... happens (the child dies) and where
..... does not happen ?
does not die)>?
3.7
(Where the child
PREVENTION OF DEATH IN DIARRHOEA
3.7.1
What are the things a mother can do to
prevent diarrhoea' from becoming serious
(USE SAME TERMINOLOGY
and the child .... ?
AS RESPONDENT)
Indian Market Research Bureau
7
ingredients/mode of preparation of
food/drinks
medicines/other treatment
frequency of feeding
4.
FEEDING
ALL RESPONSES ON FEEDING SHOULD DE ASKED SEPARATELY
FOR FOOD AND DRINK
4.1
FEEDING DURING DIARRHOEA
4.1.1
What types of foods/fluids in your
opinion should be.given to a child
who has diarrhoea ? What foods do
the mothers usually give on their
own ?
OBTAIN DETAILS OF EACH KIND OF FOOD
AND DRINK GIVEN IN TERFIS OF :
-
Ingredients used
-
Mode of preparation
-
Frequency of feeding
Amount given each time
Method of feeding
4,1.2
Why should these foods/drinks be
>
given ? FOR EACH FOOD AND DRINK
MENTIONED ASK :
•
What are the specific benefits of
each ?
4.1.3
What food/drink items, if any, should
not be given during diarrhoea ? Why ?
Do mothers give any of these foods to
children during diarrhoea ?
PROBE
............
THOROUGHLY ON THE REASONS FOR NOT
GIVING THE SAID FOOD/DRINK ITEMS
4/1 .-4
QUANTITY
How much food/drink should be given to
Indian Market Research Bureau
8
a child who has diarrhoea ? The same as before
or
. ? OBTAIN OPINION WITH RESPECT TO
THE NORMAL DIET
What is the reason for giving
amount of food ?
What do the mothers
do ? Do they do this on their own or on someone’s
suggestion ? Who’s ?
4.2
BREAST FEEDING
4.2.1
Should breast feeding/mother’s milk be continued
during diarrhoea ? Why ? Why not ? Tell me
for'both a child who is only on breast milk and
a child who is on breast milk as well as other
foods and drinks ? What do the mothers do ?
Do they do this on their own or someone
suggests it ?
IF BREAST FEEDING SHOULD BE STOPPED THEN FOR
EXCLUSIVELY BREAST FED CHILDREN ASK :
4.2.2
4.3
What should a child who drinks only mother’s
milk be given when when he/she gets diarrhoea ?
POST DIARRHOEAL FEEDING
4.3.1
What should be given to a child to eat/drink
after he/she recovers from diarrhoea ?
PROBE AROUND
:
-
type of food/drink
ingredients
-
amount
-
frequency of feeding
-
method of preparation
4.3.2
How is this different from the child's reoular
diet ?
4.3.3
For how long (days/weeks) should this diet be
continued ? Should there be a difference between
the-diet on the first day/week and the next ?
‘What do the mothers feed the children ?
9
REFER TO THE LAST CASE OF DIARRHOEA THAT RECOVERED
4.3.4
You just told me about a case that came to you
days/weeks ago, could you tell me what
food did you recommend when the child got better ?
5.
TREATMENT
OVERALL CURE
5.1
5.1.1
What treatment do you recommend for the overall
treatment of diarrhoea ?
/5.1.2
Do mothers use any home treatment to cure
diarrhoea ? What types of treatment ? How
'/
often do they use these ?
Do they use these
before coming to you ?
5.2
DEHYDRATION
5.2.1
•
■
IF DEHYDRATION MENTIONED ASK :
You mentioned that a child becomes dehydrated
when it gets diarrhoea ?
....
5.2.2
I
What treatment do
you advise to prevent dehydration ? What is
the best treatment for a dehydrated child ?
IF DEHYDRATION NOT MENTIONED PROMPT :
■
When a child has diarrhoea it loses body
fluids i.e. becomes dehydrated.
What
treatment do you advise to prevent loss
of‘body fluids ? What is the best
treatment for a child who is dehydrated ?
.
5.2.3
J
IF HOME MADE SOLUTION MENTIONED ASK :
When did you hear of this ?
you ?
Who told
What did the person/literature
say ?
IF HOME-MADE SOLUTIONS NOT MENTIONED
ASK Q 5.2.4 and 5.2.5
Indian Market Research Bureau
10
5.2.4
Are there any homemade drinks made of
sugar and salt that can be used to
prevent dehydration ? How are they
made ? ASK FOR :
-
ingredients
proportions
method of preparation
5.2.5
How often do you recommend this drink
to the patient ? For whow long should
it be taken ? How effective is it ?
5.2.6
In the last few cases of diarrhoea that
you did treat, did you recommend this
solution ?
When ?
IF RECOMMENDED ASK
5.2.7
5.3
;
If you recommended this solution how
would parents react to its suggestion ?
MEDICINES
5.3.1
What medicines should be given to a child
who has diarrhoea ? What type (ayurvedic,
homeopathic, unani) of medicines are they ?
How do they help ?
5.3.2
Do you recommend all these medicines for
all cases ? What medicine is recommended
at what stage and for which type of
diarrhoea ?
5.4
ORS AND ELECTROLYTE : SHOW ORS AND ELECTROLYTE
PACKETS SEPARATELY :
ASK FOR EACH SEPARATELY :
Indian Market Research Bureau
11
5.4.1
Have you ever recommended this to your
patients ? What frequency do you
recommend ?
5.4.2
How should the solution for this be
prepared ? How much powder and how
much water ? How do you explain this
to the mother ?
DESCRIPTION.
OBTAIN DETAILED
5.4.3
What do you think are its ingredients ?
5.4.4
How do you give it to your patients ? Do
you give the entire packet or some of it ?
How do you give it ?
5.4.5
How does it help a child who has diarrhoea ?
What does it do ?
ASK FOR EACH : ELECTROLYTE/ORS/HOMEMADE
SOLUTIONS
How often do you recommend it ?
5.4.6
MOTHERS
6.1
Do you think mothers have any beliefs/ideas about
diarrhoea treatment that could be useful/harmful
to their
children ? What|_ag° they ? How can
these be got around ?t. What/you attempted in
the past ? With what results ?
OBTAIN OPINION ON USEFUL AND HARMFUL TREATMENT
.2
What role do mothers play in curing diarrhoea ?
ASK :
a/
Length of practice ,
If practice full or part time
c/
Type of training : From where, when, which
institution etc, whether correspondence ?
d/
What type of medicine practised
e/
Where medicines bought from.
Indian Market Research Bureau
APPENDIX C5
DEPTH INTERVIEW GUIDE -• HEALTH PRACTITIONER
1.
INTRODUCTION
1.1
Introduce self
My name is
company.
1.2
...... I work for a market research
Introduce Indian Market Research Bureau
This company carries out market surveys in
different parts of the country among all
types of people.
1.3
Explain topic
Currently may company is conducting research in
many villages like this all over the country.
The research is being carried out to find out
what steps the village people take to cope with
disease and illness among children.
1.4
Explain your role
I am from the city, I know nothing about village
ways.
I am here to find out about them from you.
Also I know nothing about medicine and its
practice and would like to learn from you.
1.5
Explain doctor!s role
Since you are in contact with the village people
when their children are not well, we would like
to know your opinion, on how they cope, as well
as your recommendations and advice to them.
Indian Market Research Bureau
2
1.6
Explain tape recorder
Since we have a lot to discuss and it will not
be possible to write everything we discuss, I
have this tape recorder which will tape every
thing.
It will help me to recall later on
what we have discussed.
1.7
2.
There are no right or wrong answers.
only your opinion.
I want
GENERAL QUESTIONS
2.1
IS FOR VEDS/HAKIFiS/DOCTORS ETC
2.2
IS FOR VILLAGE HEALTH WORKERS, ANGANWADI
WORKERS ETC.
/ 2.1
What type of people
do you usually treat ?
2.2
What work do you do in villages ? Who are
the people that you usually deal with ?
2.3
FOR ALL
DISEASES AND ILLNESSES
S2.3.1
2.3.2
What are the different types of
diseases and illnesses which
occur in this village ?
Which of these diseases/illnesses
occur most often among children
aged less than 5/2 years ?
•y2.3.3
Are there any diseases/illnesses
that occur more often in certain
Indian Market Research Bureau
3
i
seasons ?
PROMPT : WINTER, MONSOON, SUMMER,
CHANGE OF WEATHER.
2.3.4
You mentioned ................................. and
diseases/illnesses, which of these in your
opinion are serious diseases/illnesses for
children ? OBTAIN A RANKING FOR ALL DISEASES/
1
2.3.5
ILLNESSES MENTIONED.
REFER TO DISEASES/ILLNESSES CONSIDERED SERIOUS
SAY :
Why do you consider these diseases/illnesses
to be serious ?
2.3.6
What do you/people fear most when a child
gets one of these ’serious’ diseases/
illnesses ?
I
3.
QUESTIONS RELATED TO DIARRHOEA
3.1
SERIOUSNESS
OF DIARRHOEA
In your opinion how serious is diarrhoea
compared to the other diseases/illnesses
---------------------- for a child less than 5/2 years ? Which
diseases/illnesses would be more or less
serious than diarrhoea ?
3.1.1
3.1.2
What do people fear most when a child
gets diarrhoea >?<
3.1.3
When does diarrhoea become serious ?
Indian Market Research Bureau
L ft
I
II i l l l l i H
3.2
CAUSES
3.2.1
What in your opinion are the causes of
diarrhoea ?
L b w f f * * ( f( ( * ( ff »*
PROBE AROUND
:
-
polluted food
unhygienic condi
tions
polluted water
part of growing up
seasonal changes
food and drink
over eating
PREVENTION
< <
< . f
What are the things that can be done to
prevent a child from getting diarrhoea ?
Have you suggested these to
the parents ?
Which ones/when ?
3.2.3
Do you know if mothers do any of these
things ?
3.2.4
If a child has already had diarrhoea
what can be done to prevent the child
from getting diarrhoea again ?
3.2.5
Do mothers do these things ?
f
r f r r r r r r lr r r r ' r r r *ft ft ft ft ft ft ft ft ft ft ft ft ft ft
f (
3.2.2
" 9"
3.3
DIFFERENT TYPES OF DIARRHOEA
*
3.3..1
How else is diarrhoea referred to or
talked of ?
f 'F F F F F F F F F F F F F F
3.3.2
3.4
What, if any, are the different types
of diarrhoea ? How are they different ?
Do they have different names ?
SYMPTOMS
3.4.1
You mentioned ...................... .. ............... 2nd
types of diarrhoea/loose
stools.
Could you tell me what happens
Indian Market Research Bureau
5
to children who get these different
types of diarrhoea ? What are the
symptoms ?
3.5
STAGES OF DIARRHOEA
3.5.1
What happens to a child when she/he
first gets diarrhoea ?
What are the
first signs ? What happens next ?
And next ? SEE IF RESPONDENTS THINK
OF DIARRHOEA IN STAGES.
USE THE SAME
TERMINOLOGY THE RESPONDENTS USE FOR
THE DIFFERENT STAGES OF, DIARRHOEA.
FOR EACH STAGE OBTAIN : PHYSICAL
DESCRIPTION :
3.5.2\
-
of the stool in terms of colour,
consistency, smell
-
physical appearance of the child
-
other symptoms
At what stage does diarrhoea become
serious ? What are the signs ?
PROBE ON
-
physical appearance
of child
u—
type of stools
amount of urine passed
other symptoms
:
1 e -
3.5.3
At what stage are infants brought to
you usually ?
3.5.4
What is the duration of one episode
of diarrhoea ?
3.6
CONSEQUENCES OF DIARRHOEA
3.6.1
What could happen, at worst, to a child
when it has diarrhoea ?
3.6.2
How many such cases of diarrhoea have
you dealt with ?
Indian Market Research Bureau
6
3.6.3
IF DEATH MENTIONED IN 3.6.1 ASK :
When does diarrhoea lead to death ? Why
do children die of diarrhoea ? What do
you think children die of ?
PROBE AROUND :
'
3.7
-
Infection
Lack of food
-
Lack of water
LAST CASES OF DIARRHOEA
3.7.1
In the last week/month, how many cases
of diarrhoea have been brought to you ?
REFER TO LAST CASE
3.7.2
When was the last diarrhoea case brought
to you ? Who brought the child to you ?
Who usually brings the child to you ?
3.7.3
How old was the child ? What kind of
family did the child belong to ? OBTAIN
INFORMATION ON :
3.7.4
-
income
-a
-
caste
occupation of main earner
What did the child look like when it
was brought to you ?
What was the
child’s condition ?
PROBE AROUND :
-
Number/type of stools
in terms of colour,
-
smell, consistency
physical appearance
-
other symptoms
ADVICE GIVEN
3.7.5
What did you recommend ? What other advice
did you give ? OBTAIN INFORMATION ON
-
food/drinks given
Indian Market Research Bureau
7
ID DIARRHOEA SEEN AS A KILLER ASK
3.8
:
Why do you think the child •••••• ?
did the child (die) of ?
PROBE AROUND :
3.8.2
What
-
Infection
-
Lack of food
Lack of water
Other factors that emerge
What makes you feel that
for (death) ?
.... was the reason
PROBE AROUND CONDITION OF CHILD IN TERMS OF :
~
dry lips
wrinkled lock/skin
thinner
weakness
was told by others
QUESTIONS ON DEHYDRATION (IF MENTIONED SPONTANEOUSLY)
4.
You mention that there is dryness/thirst.
4.1
At what
Why does this happen ?
stage does this happen ?
4.2
What effect does this dryness, thirst etc that you
mentioned have on the child’s health ?
4.3
How can this dryness etc be PREVENTED ?
can be taken ?
4.4
When .your child had diarrhoea did this happen ?
What steps
Could you describe your child then ?
a
e--
5.
----—
‘
••
—•*
•* ’*
QUESTIONS ON FEEDING
5.1
FEEDING DURING DIARRHOEA
When a child has diarrhoea/loose stools what should
be her/his diet ? What should the child be given
to eat and drink ?
OBTAIN DETAILS FOR EACH FOOD/DRINK MENTIONED IN
Q.5.1.1 AND Q.5.1.2 IN TERMS OF :
Indian Market Research Bureau
8
hygiene
Ingredients used
where ingredients obtained from ?
Plode of preparation (proportions)
When given (in relation to bach
stage) ?
How much given at a time ?
Why given i.e. what effect is the food/
drink supposed to have ?
Frequency of feeding ?
Who suggested it/how did you come to
know of it 2
5.2
DIFFERENCE IN REGULAR AND FEEDING DURING DIARRHOEA
5.2.1
You have just told me about the food and drink
you give your child during diarrhoea/loose stools.
What, if any, is the difference between this and
the child’s regular diet.'
IF MENTIONED THAT NO OR LESS FOOD AND/OR DRINK WAS
GIVEN ASK :
5.2.2
Why didn’t you give the child anything/to eat ?
PROBE AROUND :
-
the child just passed it out anway
the child gets tco weak to eat
Nothing can save the child except the
hospital/doctor/glucose drip
the ’hakim’/ved’ said not to give anything
-
the child cannot digest so much
-
Role of mother-in-law etc
-
Who told you that this should be so ?
-
5.3
FOOD/DRINKS THAT SHOULD NOT BE GIVEN
5.3.1
What food/drink items should not be given to the
child who has diarrhoea ?
Why ?
PROBE AROUND EACH FOOD/DRINK ITEM MENTIONED IN
TERMS OF :
- ingredients
- effect of food/drink
-
amount
Indian Market Research Bureau
9
5.4
BREAST FEEDING
OBTAIN THE TERMINOLOGY FOR BREAST FEEDING FROM
• THE RESPONDENTS AND USE THE SAME.
5.4.1
Should mother’s milk be continued during
diarrhoea ? Why ? Why not ? Who told
you that it should/should not be given ?
ASK FOR INFANTS WHO ARE HAVING NO OTHER
FOOD EXCEPT BREAST MILK
5.4.2
If you do not give the infant mother’s
milk during diarrhoea what else do you
give, or do you give nothing ?
5.5
RELATED TO POST DIARRHOEAL FEEDING
REFER TO LAST CASES OF DIARRHOEA :
5.5.1
What did you feed the child after he/she
was better ?
5.5.2
For how long (weeks/days) did you feed
this to your child ?
5.5.3
-
5.5.4.
. 5.5.5
Why did you feed this to your child ?
How much did you feed your child ?
: (PROBE ON DIFFERENCE FROM REGULAR
. DIET) Why ?
How did you prepare this food ?
What
were the ingredients ?
5.5.6
Who suggested/told you to give this to
the child ?
5.5.7
How long
did you continue to give this
food to the child ?
WEEKS/DAYS).
(OBTAIN NO. OF
Indian Market Research Bureau
10
6.
TREATMENT
REFER TO THE STAGES OF DIARRHOEA MENTIONED BY THE
RESPONDENT
6.1
Please think of the last time your child had
diarrhoea, What is the first thing you did when
' you saw that the child had diarrhoea ? What did
you do in the next stage ? And the next?
(WHEN
REFERRING TO EACH STAGE USE RESPONDENT LANGUAGE)
; ’
6.2
What treatment did you give your child when it
had diarrhoea ? Tell me about homemade and other
types of treatments too. What treatment is
usually given to a child who had diarrhoea ?
6.3
•.
6.4
Who recommended these treatments to you ?
J IF TAKEN TO 'VED
*,
'HAKIM1 ETC
'■ At what stage did you take it to the ’hakim’/
'ved’/doctor ? What was the child like then ?
flow much time (days/weeks) had passed ?
6.5
Who took the child to the ’hakim’/’ved’/doctor ?
6.6
What kind of ’*
,
ved
’hakim’, doctor was he ?
.(.OBTAIN. A-SKETCH-OF....THE HAKIM IN TERMS OF SIZE
OF CLINIC, NATURE OF WORK ETC)
6.7-
What did he say to you ?
he give ?
for ?
What medicines did
How long did he give you the medicines
How was the child supposed to take the
medicines ?
6.8
What happened then ? How did you know the
treatment/medicine was having an effect ?
What were the signs ?
6.9
.
’IF NOT TAKEN TO ’VED’,
’*HAKIM
',
ETC ASK :
Why didn’t you take the child to a
(USE SAME TERMINOLOGY) ?
......
Indian Market Research Bureau
6.10
HOMEMADE SUGAR SALT SOLUTION
6.10.1
Have you ever given a homemade sugar
and salt solution in water to your child
|
when she/he had diarrhoea ?
I
6.10.2
IF YES ASK : How did you prepare it ?
Who told you about it ? Did it help
the child ?
6.10.3
6.11
How was it helpful ?
IF NO ASK : Would you consider giving
it to your child ? Why/Why not ? What
are your views on the ingredients ?
ORS PACKS-: SHOW PACKETS
6.11.1
Have you seen this before ?
Have you ever used it ?
6.11.2
IF YES ASK : Who told you about it ?
-
Where have you seen it ?
-
What is it meant for ?
PREPARATION
•*
How do you use it ?
it ?
How do you make
How much do you put in how much
water ?
FREQUENCY
-
How frequently did you give it and how
match at a time ?
USE
-
How do you think it helped/helps your
child,
-
if at all ?
Will you use it again, next time your
child has diarrhoea ? Why ?
PURCHASE
nt ttttttt
Where do you get it from ?
Did you buy
it ?
Indian Market Research Bureau
12
PRICE
—
At what price did you buy it ?
-
Would you buy/use it again if your child had diarrhoea ?
Why/Why not ?
INGREDIENTS
-
6.113
What do you feel it contains ?
IF NO ASK :
This packet has a mixture of salt and sugar.
You have
to put- it into clean drinking water and give it to your
child when it has diarrhoea.
This has to be given at
regular intervals.
This only restores the water and salt
that the body loses due to diarrhoea.
What do you think of this ?
child ?
Would you give it to your
Why ? and why not ?
ASK QUESTIONS ON
-
education
-
composition of family
occupation of husband, main and subsidary
-
crops grown
radio/TV/press listening/viewing habits, if any,
-
in households
immunisation practices
7.0 COMPLETION DATA
7.1
RECORD ON TAPE AT END OF DISCUSSION :
7,1.1
No. of respondents (mothers) at the end
7.1.2
No. of mothers-in-law at the end
7.1.3
Time (at end of discussion)
7.1.4
Place of group/interview
7.1.5
Village name and data
7.1.6
Cassette No. used
Indian Market Research Bureau
13
7.1.7
Your name
7.1.8
Any other comments about any special
difficulties you had
7.2
IF ’Live diarrhoea’ RESPONDENT, RECORD :
7.2.1
Time at end of interview
7.2.2
Place
7.2.3
Village name and date
4
*
7.2
. Cassette no. used
7.2.5
Your name
7.2.6
Appearance and description of
respondent and her attitude
7.2.7
Other comments
Indian Market Research Bureau
APPENDIX C6
DEPTH INTERVIEW GUIDE - RETAIL OUTLETS
1.
INTRODUCTION
1.1
Introduce self
My name is
company.
1 •2
I work for a market research
Introduce, Indian Market Research Bureau
IMRB carries out market surveys in different
parts of the country among all types of people.
1 ®3
Exp 1 ain topi c
Currently my company is conducting research
in many villages like this all over the country.
The research is being carried out to find out
what thy village people do to fight disease
and illness among children.
1•4
Explain your role
I am from the city I know nothing about
village ways.
I am here to find out about
them from you.
Also I know nothing about
medicine and its practice and would like to
learn from you.
1.5
Explain pharmacists role
Since you provide medicine to the village
people when there is an illness in ther homes,
we would like to know about the type of
medicine doctors prescribe and the advice you
give.
1.6
Explain tape recorder
Since, we have a lot to discuss and it will
not be possible to write everything we discuss,
I have this tape recorder which will tape every
thing, later on I will hear it and write down.
1.7
There are no right or wrong answers.
I just
want to know about your experience with the
village people.
Indian Market Research Bureau
2
2.
GENERAL QUESTIONS
2.1
2.2
diseases/tllness
2.1.1
What are the different types of diseases and
illness for which you supply medicine, tonics
etc to the village people ?
2.1.2
What are the childhood illnesses for which
village people come to you for advice ?
3
*
2.1
Which of these are serious illnesses ? Tell
me about other seasons like summer, monsoons,
*
etc
change of weather too ?
STOCKED
*.eMEDICINES
*OTa.MM
trrao>mn
cs» ».
2.2.1
I
2.3
• •
What are the different types of medicines,
tonics etc
*
that you stock ? Tell me about
ayurvedic? unani, homeopathic and other
!desi? medicines too ?
ADVICE
2.3.1
Do the parents of the children who are sick
seek your advice for their child ?
2.3.2
How many such parents come to you in say, a
week/day ?
2.3.3
For which type of illnesses and diseases do
they come to you to seek advice generally ?
I «
• .
» .
• w
• -
I _
o
B
3.
QUESTIONS RELATED TO DIARRHOEA
3.1
B A
?
1
ADVICE
ON DIARRHOEA
3.1.1
How often do parents of children come to you
for advice when their child has diarrhoea ?
3.1.2
What is recommended by you ? Does this
vary by type and stage cf diarrhoea ? What
is recommended for each stage/type of
diarrhoea ?
B
1
i
B
OBTAIN DETAILS OF TREATMENT IN
TERMS OF :
-
advice
medicine
tonics
feeding
Indian Market Research Bureau
3
3.1.3
n
What are the medicines/tonics/treatment
prescribed by the docotor ?
I
*
,
3.1.4
1
3.3
Which medicines, tonics etc are recommended
by you most often ?
CURE FDR DIARRHOEA
3.3.1
Do you think that diarrhoea can be cured/
treated at home ? Why/why not ? IF YES
How can diarrhoea be cured at home ?
HOMEMADE SOLUTION
3.3.2
Have you or the village doctor/1hakim’/
’ved? ever recommended homemade sugar and
salt solution to treat diarrhoea ?
b
.IF^YES
3.3.3
3.4
« Where did you hear about it ?
- How is this solution prepared ?
- How much of each ingredient is used ?
- How does it help in diarrhoea
- How is it different from plain water in
the treatment of diarrhoea ?
AVAILABILITY OF DIARRHOEA MEDICINES ETC
3.4.1
Are the medicines, tonics and other aids
for diarrhoea cure easily available ?
Have you ever felt a shortage ? When ?
For what ?
1 w
3.5
*
ORS
3.5.1
IF ORS NOT MENTIONED ASK ;
Have you ever heard of ORS and electro
lytes ? SHOW ONE PACKET OF EACH AND
ASK ALL :
Have you seen this before ?
i *_
r
1 *
1
1
1
3.5.2
What do you think are its ingredients ?
How is it prepared ? How frequently
should it be had ?
3.5.3
For what other kinds of illnesses do you
recommend ORS and electrolytes ? OBTAIN
ANSWERS FOR EACH SEPARATELY
Indian Market Research Bureau
4
3.5.4
Are these and other medicines for diarrhoea
recommended by you/doctor for a patient at
the same time ?
FOR DOTH YES AND NO ASK :
When are they recommended ?
ASK
—
What training have you had in this field ?
—
What other occupations do you have ? How much
time do you spend here and on other jobs ?
-
For how long have you been dispensing medicines
from this store ?
What, apart from medicines, are the other products
that you stock in your store ?
~
From where do you buy your medicines ?
Indian Market Research Bureau
Position: 4700 (1 views)