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EFFECT OF HEALTH EDUCATION ON CAREGIVERS’ KNOWLEDGE, ATTITUDE AND PRACTICE OF HOME-MANAGEMENT OF ACUTE RESPIRATORY INFECTIONS IN UNDER-FIVES IN ISSELE-AZAGBA, DELTA STATE
Abstract
SUMMARY
Introduction – Acute respiratory infections (ARIs) are one of the leading causes of under-five mortality especially in developing countries. Caregivers play a major role in the management of under-five ARIs. The aim of this study was to assess the effect of health education on caregivers’ knowledge, attitude and practice of appropriate home management of ARIs in under-fives in Issele-Azagba, Delta state.
Materials and methods – A non-randomized, controlled intervention study was carried out among 139 caregivers of under-fives in Issele-Azagba, Delta state using 139 caregivers of under-fives in Ekwuoma community also in Delta state as controls. The respondents were selected using a multi-stage sampling method from both groups. Baseline data was collected using a pre-tested, semi-structured, interviewer administered questionnaire. A health education programme based on the ‘Health Belief Model’ was carried out among the caregivers in the intervention group using a video clip, flipchart, role plays, health talks, information leaflets and posters. Post-intervention data collection took place three months later. Epi-info 2008 version was employed in the data analysis.
Results – A total of 278 caregivers of under-fives participated in the baseline study. Awareness of home-management of ARIs among the respondents increased from 78.4% at baseline to 100% post intervention in the intervention group and from 88.5% to 89.2% in the control group. All the respondents (100%) in the intervention and 98.6% in control groups respectively had poor level of knowledge at baseline. Majority of the respondents (97.1% in the intervention group and 86.3% in the control group) had negative attitude towards home management of ARIs at baseline. Also, majority of the respondents (94.2%) in both intervention and control groups respectively had poor level of practice of appropriate home management of ARIs in under-fives at baseline. Under-fives with symptoms of ARI were dressed in warm clothes when it was cold by 26.5% and 21.6% of respondents in the intervention and control groups respectively. None of the respondents in the intervention group and 2.7% in the control had practiced steam inhalation. Only 2.4% of the respondents in the intervention group and 9.5% in the control group had given the sick child warm drinks. Only 2.4% and 2.7% in the intervention and control groups respectively had washed their hands with soap and water in association with managing under-five ARIs at home. Regarding inappropriate management, majority of the respondents (75.9% in the intervention and 56.8% in the control group) had inappropriately given antibiotics and 68.8% in the intervention and 54.1% in the control group respectively had given cough syrup for the treatment of common cold/viral ARIs at home. Post intervention, in the general performance score, there was a statistically significant increase of 41% in the proportion of respondents with a better level of knowledge in the intervention group from baseline. (P<0.05) Also, the proportion of respondents with positive attitude increased significantly by 77% from baseline. There was also a statistically significant increase in the proportion of respondents with a better level of practice in the intervention group by 30.9% from baseline. There was no statistically significant positive change observed in the awareness, knowledge, attitude or practice of the respondents in the control group, post intervention.
Conclusion: The health education programme was effective at improving the knowledge, modifying the attitude and improving the practices of caregivers regarding appropriate home management of ARIs in under-fives in the intervention group.
Recommendations: To strengthen community health education of caregivers especially mothers and to train community resource persons on appropriate home management of ARIs in under-fives. These interventions should be aimed at prevention, identification danger signs and timely home-management of ARI cases.
