KNOWLEDGE AND PRACTICE TOWARDS CHILDHOOD DIARRHEA PREVENTION AMONG MOTHERS IN EDO STATE SPECIALIST HOSPITAL BENIN CITY

Abstract

The study focused on investigating the knowledge and practices towards childhood diarrhea prevention among mothers at Edo State Specialist Hospital in Benin City. A quantitative survey research design was employed to gather insights into the factors contributing to diarrhea occurrence in this vulnerable population. A structured questionnaire was meticulously designed and administered to a purposive sample of 120 respondents, representing 10% of the target population. The data collected were meticulously analyzed using SPSS27 software, which facilitated the presentation and analysis of the gathered data. In particular, a one-sample t-test was utilized to test hypotheses regarding associations between socio-economic factors, water and sanitation practices, caregiver knowledge, attitudes, practices related to diarrhea prevention, and the prevalence of diarrhea among children. Upon analysis, the findings revealed significant associations between socio-economic status, water and sanitation practices, caregiver knowledge, attitudes, practices, and the prevalence of diarrhea among under-five children. Specifically, improved water and sanitation practices were found to be associated with lower rates of diarrhea among children attending the immunization clinic. Mothers with better knowledge, positive attitudes, and good practices related to diarrhea prevention and management were also found to have children with lower rates of diarrhea. However, the study also identified limitations, including potential response bias in self-reported data and the cross-sectional design's inability to establish causality definitively. In conclusion, the study findings underscored the critical importance of targeted interventions aimed at improving water and sanitation infrastructure, enhancing health education and awareness among mothers, especially those from lower socio-economic backgrounds, and integrating diarrhea prevention strategies into routine healthcare services. The study recommends promoting handwashing and hygiene practices, providing socio-economic support to vulnerable families, and leveraging immunization clinics as platforms for comprehensive child health services. These insights contribute significantly to the evidence base for developing effective public health strategies aimed at reducing diarrhea prevalence among under-five children in similar healthcare settings.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Diarrhea remains a significant public health concern globally, especially among under-five children in developing countries like Nigeria (Getachew et al., 2018). According to the World Health Organization (WHO), diarrhea is one of the leading causes of morbidity and mortality in children under five years old (Levy et al., 2019). In Nigeria, the burden of diarrhea is particularly high, contributing significantly to childhood mortality rates (Dairo et al., 2017). Understanding the prevalence and determinants of diarrhea among under-five children is crucial for designing effective interventions and policies to combat this health challenge (Asif et al., 2019).

The prevalence of diarrhea among under-five children in Nigeria is influenced by various factors, including socio-demographic characteristics and environmental conditions (Jonadu et al., 2021). Factors such as poor sanitation, inadequate access to clean water, and low socio-economic status contribute to the high prevalence of diarrhea in this age group (Guerrant et al., 2020). Additionally, the seasonality of diarrheal diseases, especially during the rainy season, exacerbates the problem (Levy et al., 2019). These factors underscore the complexity of addressing diarrhea among under-five children in Nigeria and similar settings.

Efforts to combat diarrhea in Nigeria have included vaccination programs, improved water and sanitation infrastructure, and health education campaigns (Mogrena et al., 2021). However, challenges such as vaccine coverage gaps, limited access to clean water and sanitation facilities in rural areas, and inadequate healthcare resources continue to hinder progress (Naing et al., 2020). Sustainable interventions that address these multifaceted challenges are essential to reducing the burden of diarrhea among under-five children in Nigeria.

The impact of diarrhea on child health goes beyond immediate morbidity and mortality. It can also lead to long-term consequences such as malnutrition (Ferdous et al., 2023). Diarrhea prevents catch-up growth, and malnutrition, in turn, increases the frequency and duration of diarrhea episodes (Guerrant et al., 2020). This vicious cycle highlights the interconnectedness of diarrheal diseases with broader health and development outcomes among under-five children.

Addressing the prevalence and determinants of diarrhea among under-five children requires a holistic approach that integrates healthcare, water and sanitation infrastructure development, and community education (Anyorikeya et al., 2020). Maternal education plays a crucial role in preventing childhood diarrhea, emphasizing the importance of health literacy and empowerment (Desmenu et al., 2017). Additionally, interventions such as rotavirus vaccination have shown effectiveness in reducing diarrheal morbidity and mortality (Mogrena et al., 2021). These strategies, combined with improved access to healthcare services and socio-economic empowerment, can contribute to sustainable reductions in childhood diarrhea rates.

1.2 Statement of Problem

The prevalence of diarrhea among under-five children in Nigeria presents several gaps in our understanding that require urgent attention. Despite efforts to combat this issue, particularly in developing countries like Nigeria, the burden of diarrhea remains disproportionately high among young children. The specific prevalence rates of diarrhea among under-five children in different regions of Nigeria are not well-documented, indicating a need for more granular data at the state and community levels. Understanding these rates is crucial for targeted interventions and resource allocation.

Moreover, there is a lack of comprehensive exploration into the socio-demographic factors contributing to diarrhea prevalence among under-five children. Factors such as income levels, education, and access to healthcare services play significant roles but require more in-depth investigation to inform effective public health strategies.

Additionally, there is limited research on the seasonality and environmental factors influencing diarrhea outbreaks among children in Nigeria. Understanding these factors, such as water contamination during rainy seasons and sanitation practices, is essential for developing preventive strategies tailored to local conditions.

While vaccination programs have been implemented, there are gaps in vaccine coverage and awareness among mothers, hindering efforts to reduce diarrheal morbidity and mortality. Addressing these gaps requires a deeper understanding of the barriers to vaccination and innovative approaches to improve coverage rates and caregiver education.

Longitudinal studies are also needed to assess the long-term impacts of diarrhea on child health, including nutritional outcomes and developmental milestones. This holistic approach will provide a comprehensive understanding of the challenges posed by diarrhea among under-five children in Nigeria and guide evidence-based interventions for sustainable health outcomes.

1.3 Objectives of the Study

The specific objectives of this study include to::

1. Determine the prevalence of diarrhea among under-five children attending the immunization clinic at Edo State Specialist Hospital, Benin City.

2. Identify the determinants (such as socio-economic status, water and sanitation practices, breastfeeding practices, etc.) associated with diarrhea among under-five children in the same clinic.

3. Assess the knowledge, attitudes, and practices related to diarrhea prevention and management among mothers of under-five children attending the immunization clinic.

1.4 Research Questions

The following research questions were asked:

1. What is the prevalence of diarrhea among under-five children attending the immunization clinic at Edo State Specialist Hospital, Benin City?

2. What are the socio-economic and environmental determinants associated with diarrhea among under-five children in the same clinic?

3. What are the knowledge, attitudes, and practices of mothers related to diarrhea prevention and management?

1.5 Research Hypotheses

The following hypotheses were tested:

1. There is no significant association between socio-economic status and the prevalence of diarrhea among under-five children attending the immunization clinic.

2. Improved water and sanitation practices are not associated with lower rates of diarrhea among under-five children.

3. Mothers with better knowledge, positive attitudes, and good practices related to diarrhea prevention and management do not have children with lower rates of diarrhea.

1.6 Significance of the Study

The findings of this study hold significant promise in advancing our understanding of diarrhea among under-five children, especially those engaging with immunization clinics. This contribution extends to the broader context of healthcare policies and interventions, particularly in regions like Edo State and similar settings grappling with high rates of diarrhea among young children. Through a nuanced comprehension of the determinants and prevalence of diarrhea, healthcare providers and policymakers stand to benefit immensely by implementing targeted strategies aimed at enhancing child health outcomes.

The impact of diarrhea on children's health cannot be overstated, especially in resource-limited settings where access to quality healthcare and sanitation facilities may be constrained. By delving into the specific prevalence rates and factors influencing diarrhea among under-five children, this study adds valuable insights to the existing body of knowledge. These insights can serve as a roadmap for designing and implementing evidence-based interventions that directly address the root causes of diarrhea, leading to improved health outcomes for children in Edo State and similar contexts.

One of the primary advantages of understanding the determinants and prevalence of diarrhea is the ability to tailor interventions to specific populations and settings. Rather than adopting a one-size-fits-all approach, healthcare providers and policymakers can leverage this knowledge to develop targeted strategies that resonate with the local context. For instance, if the study identifies sanitation practices or water quality as significant contributors to diarrhea prevalence, interventions can focus on improving access to clean water sources and promoting hygienic practices within communities.

Furthermore, the findings of this study can inform policy formulation and resource allocation at both the state and national levels. By highlighting the burden of diarrhea among under-five children and elucidating the factors contributing to this burden, policymakers can prioritize investments in areas such as healthcare infrastructure, sanitation facilities, and health education programs. Such targeted investments have the potential to yield substantial returns in terms of reduced morbidity and mortality rates associated with diarrhea.

Moreover, the study's insights can guide healthcare providers in implementing evidence-based practices within clinical settings. For example, understanding the prevalence of diarrhea-related risk factors among children attending immunization clinics can prompt healthcare providers to incorporate preventive measures and health education initiatives during routine immunization visits. This proactive approach not only addresses immediate health concerns but also contributes to building a foundation of lifelong health for children in the community.

In essence, the findings of this study serve as a catalyst for positive change in the realm of child health, particularly concerning diarrhea prevention and management. By bridging the gap between research and practice, this study contributes significantly to advancing child health outcomes in Edo State and similar regions, ultimately paving the way for healthier and thriving communities.

1.7 Scope of the Study

This study focuses on under-five children attending the immunization clinic at Edo State Specialist Hospital, Benin City. It covers the prevalence of diarrhea, socio-economic determinants, water and sanitation practices, breastfeeding practices, and caregiver knowledge, attitudes, and practices related to diarrhea. The study does not include children outside the specified age group or those attending other healthcare facilities.

1.8 Operational Definition of Terms

Diarrhea: Passage of loose, watery stools at least three times within a 24-hour period.

Under-five children: Children between the ages of 0 to 59 months.

Immunization clinic: A healthcare facility specializing in administering vaccines to prevent infectious diseases.

Prevalence: The proportion of individuals in a population with a particular condition or characteristic at a specific point in time.

Determinants: Factors that influence the occurrence or distribution of a health condition.

Socio-economic status: A measure of an individual or family's economic and social position based on income, education, and occupation.

Water and sanitation practices: Behaviors related to the use of clean water and hygienic sanitation facilities.

Breastfeeding practices: Methods and frequency of feeding infants and young children with breast milk.