Assessment of Mothers’ Knowledge and Practices Regarding Home-Based Management of Under-Five Diarrhoea in John Laing, Lusaka, Zambia: A Cross-Sectional Study

Background: Childhood diarrhoea remains an important cause of illness and death among children younger than five years, with dehydration and inappropriate or delayed management contributing to poor outcomes. In many households, mothers are central to the initial management of diarrhoeal episodes. This study assessed mothers’ knowledge and reported household practices regarding home-based management of under-five diarrhoea in John Laing, Lusaka, Zambia.
Methods: A quantitative cross-sectional descriptive study was conducted among 138 mothers of children younger than five years who were residents of John Laing Compound and attended under-five services at Kanyama Level 1 Hospital. John Laing A and B were used to identify the study area, and eligible participants were selected as described in the study protocol. Data were collected using an interviewer-administered, closed-ended questionnaire and analysed using SPSS. Knowledge and reported practices were assessed using separate questionnaire items covering diarrhoea management, hygiene, sanitation, water, and prevention. Responses were analysed at item level; no composite knowledge or practice score was calculated. The reported ANOVA model involving family income assistance and diarrhoea-related variables was also examined.
Results: Of the 138 respondents, 69.6% were married, 19.6% were single and 10.9% were divorced. Half of respondents (50.0%) reported washing their hands after changing a baby, while smaller proportions reported handwashing before feeding (12.3%), before food preparation (12.3%), after feeding (13.8%), after disposing of baby waste (7.2%), after washing nappies (2.2%), or after using the toilet (2.2%). Baby stool was disposed of in toilets by 58.7%, disposable bins by 23.2%, and refuse pits by 18.1%. During diarrhoeal episodes, 50.7% gave less fluid, 5.1% the same amount, and 44.2% more fluid. For solid food, 28.3% gave none, 53.6% less, 6.5% the same amount, and 11.6% more. Regarding prevention, 45.7% identified drinking clean water, 26.8% frequent handwashing, 18.8% warming leftover foods, 5.8% thorough cooking, and 2.9% preparing food in a clean environment. Most respondents (92.8%) reported washing their hands after changing nappies. Pipe water was the main reported water source (80.4%), while 56.5% reported taking measures to make water safe. The reported ANOVA model was statistically significant (F=11.417, p<0.001), but its specification does not establish that family income predicts diarrhoea occurrence.
Conclusions: The findings demonstrate important gaps in mothers’ knowledge and reported household practices concerning home-based management of under-five diarrhoea, particularly regarding fluid and food intake during diarrhoeal episodes, hand hygiene, stool disposal, and household water treatment. Because no composite knowledge or practice score was calculated, the findings should be interpreted from the individual questionnaire responses rather than as an overall knowledge or practice rating. Community health education should emphasise appropriate home management, hygiene, sanitation, safe water, and prevention.

The study was conducted in John Laing Compound, Lusaka District, Zambia, including John Laing A and John Laing B.

1. Arabi, M., Frongillo, E.A., Avula, R. and Mangasaryan, N. (2012) ‘Infant and young child feeding in developing countries’, Child Development, 83(1), pp. 32–45. doi:10.1111/j.1467-8624.2011.01675. [Google Scholar] [Crossref]

2. Das, J.K., Salam, R.A. and Bhutta, Z.A. (2014) ‘Global burden of childhood diarrhea and interventions’, Current Opinion in Infectious Diseases, 27(5), pp. 451–458. doi:10.1097/QCO.0000000000000096. [Google Scholar] [Crossref]

3. Hamuganyu, I. (2014) Correlates of diarrhoea among the under-fives in Namwala District, Zambia. Dissertation. Lusaka: University of Zambia. [Google Scholar] [Crossref]

4. Irena, H.A., Mulenga, V. and Mwambazi, M. (2011) ‘Diarrhoea is a major killer of children with severe acute malnutrition admitted to in-patient set in Lusaka, Zambia’, Nutrition Journal, 10, p. 110. [Google Scholar] [Crossref]

5. Jha, N., Singh, R. and Baral, D. (2009) ‘Knowledge, attitude and practices of mothers regarding home management of acute diarrhoea in Sunsari, Nepal’, Nepal Medical College Journal, 8, pp. 27–30. [Google Scholar] [Crossref]

6. Khalili, M., Mirshahi, M., Zarghami, A., Rajabnia, M.C. and Farahmand, F. (2013) ‘Maternal knowledge and practice regarding childhood diarrhoea and diet in Zahedan, Iran’, Health Scope, 2(1), [Google Scholar] [Crossref]

7. Liu, L., Johnson, H.L., Cousens, S., Perin, J., Scott, S. and Lawn, J.E. (2012) ‘Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000’, The Lancet, 379, pp. 2151–2161. [Google Scholar] [Crossref]

8. MacDonald, S.E., Moralejo, M.N. and Matthews, M.K. (2011) ‘Maternal understanding of diarrhoea-related dehydration and its influence on ORS use in Indonesia’, Asia Pacific Journal of Public Health, [Google Scholar] [Crossref]

9. Mengistie, B., Berhane, Y. and Worku, A. (2012) ‘Predictors of oral rehydration therapy use among under-five children with diarrhea in Eastern Ethiopia: a community-based case control study. [Google Scholar] [Crossref]

10. Mengistie, B., Berhane, Y. and Worku, A. (2013) ‘Prevalence of diarrhoea and associated risk factors among children under-five years of age in Eastern Ethiopia: a cross-sectional study’, Open Journal of Preventive Medicine, 3(7), pp. 446–453. doi:10.4236/ojpm.2013.37060. [Google Scholar] [Crossref]

11. Othero, D.M., Orago, A.S. and Groenewegen, T. (2009) ‘Home management of diarrhoea among under-fives in rural community in Kenya: household perceptions and practices’, East African Journal of Public Health, 5(3), pp. 142–146. [Google Scholar] [Crossref]

12. Rokkappanavar, K., Nigudgi, S.R. and Ghooli, S.A. (2016) ‘Study on knowledge and practice of mothers of under-five children regarding management of diarrhoea in urban field practice area of MRMC, Kalburgi, Karnataka, India International Journal of Community Medicine and Public Health. [Google Scholar] [Crossref]

13. Shah, D., Choudhury, P., Gupta, P., Mathew, J.L., Gera, T. and Gogia, S. (2012) ‘Promoting appropriate management of diarrhoea: a systematic review of literature for advocacy and action’, Indian Paediatric [Google Scholar] [Crossref]

14. UNICEF and WHO (2013) Diarrhoea: why children are still dying and what can be done. New York/Geneva: United Nations Children’s Fund/World Health Organization. [Google Scholar] [Crossref]

15. WHO (2017) Guidelines for the control of shigellosis, including epidemics due to shigella. Geneva: World Health Organization. [Google Scholar] [Crossref]

• Knowledge Management and Academic Libraries in Digital Era: Problems and Positions