India ThailandDirect Consumer experience during ailment

AcidityAcidity related problems were associated with a feeling of "irritability", "not being in the right mood to do anything". Their irritation would show up especially in their relationship with their family, such as "shouting and getting irritated with chilso that they can get back with their daily work routinesDiarrheaDiarrhea evokes feelings of being "cramped" and "confined" like wanting to sleep because of weakness. There is an urge to get emotional support and advice from family members. There is also a likely concern of embarrassment in front of outsConstipationConstipation is also associated with feelings of being unable to work, and wanting to relax and sleep all day. The discomfort of constipation especially worsens with constant gases and stomach and head aches

Desired Consumer experience

Overall, stomach ailment sufferers desire "smiling freedom" from stomach problems (feeling of lightness "Halka Phulka").so that they can get back with their daily work routines and fulfill their roles (housewife/mother etc)

Awareness of ailments

Consumers can differentiate well between stomach ailments. Verbalisations are Acidity, heartburn (Jalan), constant burping (Khatti dhakaar) and vomitting (Ulti).

There is clear awareness of stomach problems faced in the family. They are in a position to diagnose problems most often caused amongst children and Adults

perceived causes Food habits, lifestyles and rainy seasons appear to be the 3 key perceived causes of stomach problems. Specifically, it is perceived that overeating (either while going out for outings or during festive seasons), spicy food and a stressed out working l "As one grows up, the resistance of the stomach becomes lesser and lesser. That’s why older people have more stomach problems".

Eating outside food in restaurants and stale seafood tends to cause Indigestion and diarrhea. Weekend eating in restaurants is also important reasons for suffering due to oily pungent food - Celebrations like Birthdays / New Year

Awareness of medications

Awareness is specially high for "safe" and "natural" traditional medicines like Nutmeg (Jayphal), Khus-khus, Harda, Kadhwa. Those who suffer (and / or the housewife) are well aware that there are specific medicines for each problem. The popular brands of antacids are Eno, Gelucil, Digene and Pudin Hara. Of these, Eno and Pudin Hara are advertised brands while Digene and Gelucil are Rx brands (although they are commonly purchased over the counter).· Lomotil, Dependal and Enteroquino.

Only Mag77 & Eno are advertised on TV and have a good recall. The popular brands of antacids are Mag 77, Antacil and Eno. Both Mag 77 and Eno are advertised on television. Herbal remedies like Yatatsi, Yatatkao and Yakiyo are also very popular for treating acidity.There are no popular brands for treating constipation.

attitude towards medication

· "It is worth it spending on self-medication for adults, rather than worsening the problem and later having to spend money on doctor’s fees, and more expensive medicines later". · Amongst progressive households, "Traditional medicines were good with traditional food. With our new eating habits, it is important to medicate with the new branded medicines".For new brands, TV advertising plays a major role in influencing trial (especially true for antacids). There is a willingness to try different brands of antacids (primarily because antacids are not perceived to be serious medication). So often multiple brands are present in the household with one brand being the preferred one. There is, however, a barrier to trying out new brands without doctor/chemist’s recommendation in lower SEC households.

Visiting doctors is decided only if ailment has not subsided and is chronic. (Doctor Visits perceived expensive). Purchase - Antibiotics are purchased only after consulting Doctor.

Treatment There is a belief that the stomach, like any other part of the body, needs rest. Hence if very rich food has been eaten for a certain meal, then an effort is made to eat light/easy to digest food for

take specific medication based on specific stomach ailmentsHome remedies are preferred to be used for stomach

subsequent meals.Churans or other home remedy ingredients which are crushed and eaten. Eno & Pudin Hara are the most commonly known for reducing stomach pains due to overeating. Gelusil and Digene are commonly used for acidity.

Typically, when the ailment first strikes, treatment is only through home remedies for the first day. If there is no relief after a day or so, then the treatment moves to OTC medication. If the ailment still does not improve and it hampers the day to day activities of the sufferer, then a doctor is consulted (see ANNEXURE 3 for further details).Chronic/Serious sufferers usually skip the first two stages and directly visit a doctor on suffering. Similarly, children also are taken to a doctor sooner than adults.

ailments as they are safe and have no side effects

Influencers Home remedies taught/passed on by grandparents/elders in the family.Eno Usage driven by advertising. Digene/Gelucil have taken the Rx-OTC route and are now commonly used. Purchase decision is based on past experience with the brands, recommendation from friends, relatives and doctor’s or chemist’s recommendation.

Source of awareness of medicines is from Pharmacist & friends

Attitude towards visiting the Doctor

Consumers are reluctant to visit a doctor for common stomach ailments and would do so only if the ailment hampers performance of day to day activities. This is because visiting a doctor is relatively expensive and time consuming.

Doctor visits are more frequent among recurrent sufferers in Thailand than in India. This is because while in India the sufferer is aware of the medication that is prescribed and can buy it directly from a chemist, this information is not revealed by Thai doctors (who give medicines themselves) forcing the sufferer to return to the doctor every time he suffers.

What does this mean for the Indian housewife ?There are strong family dynamics when housewives suffer from stomach problems as she cannot completely fulfill her roles.How interactions are affected:Husband/in laws : Housewives feel that other family members expect a lot from her and are dissatisfied when she is unwell.They might also see her as lazy and not competent. Housewives feel that to some extent, their husbands and in-laws have a selfish motive for them getting well soon so that they can carry out with their tasks of a housewife uninterruptedChildren : Children are considered to be the most concerned when their mothers do not get well soon. Housewives feel that they keep inquiring about their mother’s illness and are surprised that they can’t take care of them as they normally do

It evokes feelings of "what should I do next", and an anxiety to get better.While she tries out home remedies they do not provide complete relief and she feels that the problem only gets "little better" or a temporary feeling of relief. She considers Diet control as an essential rather than a reliever. She tries the medications she knows and resorts to a doctor only if absolutely needed.