Does social status predict appropriate treatment of child diarrheal disease? evidence from Peru

Background: Diarrheal disease is a significant cause of morbidity among Peruvian children. Oral rehydration therapy (ORT) is a cost-effective, evidence-based approach to treat diarrhea in children under 5, yet many children in poorer households do not receive this treatment. In the context of widespread access to ORT in most Peruvian communities and Peru's national health insurance program, this study investigates social determinants of care seeking behavior and appropriate home treatment for diarrheal episodes in a nationally-representative sample of mothers. Methods: We used the Peru 2008 Demographic and Health Survey to: 1) Describe the burden of diarrheal disease among children under 5 Peru, and 2) Identify socioeconomic correlates of health-seeking behavior and utilization/appropriateness of treatment among mothers of children (N=4,778) with recent diarrheal episodes in relation to household socioeconomic status. Preliminary Results: Diarrheal disease prevalence is twice as high among poor (20.0%) compared with wealthier (9.2%) children; and among urban-dwelling (17.0%) compared with rural (13.8%) children. Mother's education and household wealth are significant predictors of seeking care for diarrhea, but not of appropriate home treatment, and this pattern holds in urban and rural areas. Although ORT is widely available, preliminary analysis shows that few mothers know about (35%) and fewer use (13%) it for recent diarrheal episodes. Conclusion: Results confirm that higher wealth and education predict care-seeking, but not appropriate home treatment. Interventions to improve appropriate home treatment of diarrhea should target all mothers regardless of socioeconomic status. Future studies will need to address specific barriers to seeking and utilizing ORT.