Acute respiratory illnesses in children under five years in Indramayu, west Java, Indonesia: a rapid ethnographic assessment.

A rapid, focused ethnographic study was carried out in a rural area of West Java, Indonesia to identify local beliefs, perceptions, and practices surrounding acute respiratory infections (ARI) in infants and young children. The study incorporates key informant interviews, open-ended interviews, and structured data collection from fifty mothers of young children selected to represent the geographical settlement pattern in the area: structured interviews with biomedical and indigenous health care providers; and structured interviews with fifty mothers who sought health care for an infant or young child with a respiratory illness. The most commonly perceived cause for ARI in children was air entering the body through some type of chill, exposure to draft or breeze, or change of weather. When fever or difficult breathing was present, mothers tended to increase the number and diversity the types of medicines used. Mothers recognized difficult as well as rapid breathing, both being described as "difficult breathing." More concern was expressed about fever than about difficulty in breathing. Effective medical care was more likely to be delayed for infants than for older children; infants were also more likely to be taken to an indigenous healer as the first-choice provider. Infants were less likely to receive an effective drug regimen even if appropriate medication was prescribed, because mothers commonly take the drugs in order to deliver them to the infant through breast milk.