Table 4 Causes of diarrhea – as reported* by Mothers (M), Fathers (F) and Older Female Caretakers (C) in villages near (< 3 miles) health facilities across 4 districts in Sierra Leone

Diarrhea Causes

1.0 Contamination

1.1 Insects transferring germs through bites or landing on food

Flies (transfer material from feces to food/nipple)

M, F, C

C

F

M, F, C

M, M

Worms (in child’s stomach)

M, C

C

C

1.2 Exposure to contaminated physical environment

Playing in dirt, child playing with own feces, sharing a toilet with an individual who has diarrhea

M

F, C

M, C

M

M

Feces near homes

M

F

F

Exposure to contaminated food and utensils (uncooked meat or fish, uncovered food, eating food off the ground)

M, F, C,

M, F, C,

M, F, C

M, F,

M, M

C

C, M

Exposure to contaminated drinking water

M, F, C

M, F, C

F, C

M, F

M, M

M, M, C

M

Exposure to contaminated nipple (sweaty, dirty)

M

M, F, C

M

1.3 Poor hygiene

Handfeeding

C

M, M

M, F, M

Unwashed hands of either child or mother (without mention of handfeeding)

F, C

M, F

M

Wearing dirty clothes (child)

M

2.0 Spoiled Breastmilk

2.1 Exposure to contaminated breast milk

Contamination due to sexual relations

F

F, C

M

M, F, C

C

Contamination due to overheated milk in breasts

M, F, C

M, F, C, M

F

M, F, C

M, M, C

Contamination due to a mother breastfeeding while pregnant/menses

M

3.0 Action of External Agents

Malevolent Sprits, witches, angry ancestors, the will of God

C

M, F, C

C

C

M

4.0 Imbalance

4.1 Dietary

Eating too much of a certain food or a bad mix of food

M, F, C

M

M,

M, F

M, M

M

A sudden change in child’s diet (i.e. children eating new foods when they begin being cared for by grandmothers)

M

Weaning

M, C

M, M

M