Management Practices of Acute Diarrhoea by Caregivers of Children Under Five Years in Mathare Informal Settlement, Nairobi City County, Kenya
Djounfoune, Arnaud Guillaume
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Diarrhoea continues to remain one of the main and the second most significant cause of death globally in children under five years. The number of diarrhoea cases continues to increase every year and is estimated to be 1.7 billion annually. In 2018, in Kenya, 1,499,146 cases of diarrhoea were reported among children under five years and Nairobi accounted for 136, 028 cases. A research in Nairobi Informal Settlements showed that 25.6% of children living in the Informal Settlement had diarrhoea. Caregivers in Mathare reported that their children contract diarrhoea at least once every two weeks. As diarrhoea is mostly managed at home by caregivers there is need to determine the management practices of acute diarrhoea by caregivers of children under five years. The main objective of the research was to determine the management practices of acute diarrhoea by caregivers of children under five years in Mathare Informal Settlement. To achieve this objective, a cross-sectional study design was used. It was preferred because it is a one point of time study. Due to its pollution and diarrhoea frequency reported by caregivers, Mathare Informal Settlement was purposively selected. For the choice of households and respondents, simple random sampling was used. Researcher administered questionnaire and observation checklist were completed appropriately. Fisher’s and exact test, Pearson Chi-square as well as Pearson correlation were utilized in the analysis. P < 0.05 was considered as statistically significant. Age of the caregivers ranged from 18-72 years old. The main age group of caregivers was 25-31 years old with 56.17%. The household size ranged from 2 to 15. Children under five years living in the selected households of the study ranged from 1 to 7 per household. Children who were 1 per household accounted for 49.4%. Mothers accounted for 83.6%. Prevalence of diarrhoea among children was 18.7%. Sex of the caregiver (p=0.008), relationship of the caregiver (p<0.001), number of household residents (p<0.001), and number of children under five years in the household (p<0.001) were found to be statistically significant with diarrhoea prevalence among children aged zero to less than five years. Knowledge level of caregivers regarding management practices of acute diarrhoea was found to be statistically significant with prevalence of diarrhoea in children under five years (p=0.020). Majority of the respondents (63.89%) used drugs from hospitals to manage diarrhoea. In 63.89%, water was given like any other day during diarrhoea. One hundred and seventy six caregivers breastfed the child during the survey. The majority of the respondents (52.78%) had no formal education. Faeces, flies and open garbage were present near or within the household in 37.72%, 59.26%, and 80.25% respectively. All the respondents washed their hands during the study. However 27.78% of the respondents did not wash their hands after disposing the child faeces. Caregivers disposed the child stool in garbage in 38.89 %. Fifty caregivers did not take their children for immunization. Statistical significance was observed between diarrhoea prevalence and the caregiver’s educational level (p<0.001), renting (p=0.024), existence of flies near or within the household (p<0.001), existence of faeces near or within the household (p<0.001), existence of open garbage near or within the household (p<0.001), immunization of children (p<0.001), age when the children start using latrine (p<0.001).In conclusion, low knowledge level was a predictor of diarrhoea among children under five years. Many factors such as existence of open garbage near or within the household and immunization practices were found to be associated with diarrhoeal prevalence among children under five years. It is therefore recommended that there is need for public health education and promotion in the study area.