Exploring knowledge on danger signs of common childhood illnesses and associated factors among mothers of under-five children in central tigrai, ethiopia: A cross-sectional study

  • GERMS, Volume 10, No. 1, Year 2020

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Study Justification:
This study aimed to assess the knowledge of mothers and associated factors on general danger signs of common childhood illnesses among under-five children in Central Tigrai, Ethiopia. The justification for this study is that a large number of under-five deaths globally are caused by preventable and treatable common childhood illnesses. Early identification of danger signs and appropriate treatment can help reduce morbidity and mortality. Therefore, understanding the knowledge levels of mothers and the factors associated with it is crucial for developing effective interventions to improve child health outcomes.
Highlights:
– The study found that only 44.7% of mothers had good knowledge of general danger signs of common childhood illnesses.
– Maternal educational status, occupation, childbirth order, and source of information were significantly associated with mothers’ knowledge.
– The findings highlight the need for intervention modalities to improve educational levels, implement behavioral change communication activities, and enhance access to health visits for mothers.
Recommendations:
Based on the study findings, the following recommendations are made:
1. Develop and implement educational programs targeting mothers to improve their knowledge of general danger signs of common childhood illnesses.
2. Conduct behavioral change communication activities to promote awareness and understanding of danger signs among mothers.
3. Strengthen access to health visits for mothers, providing them with opportunities to learn about danger signs and seek appropriate care for their children.
Key Role Players:
1. Ministry of Health: Responsible for developing and implementing educational programs and policies related to child health.
2. Health Extension Workers: Involved in community-based health education and promotion activities.
3. Non-Governmental Organizations: Collaborate with the government to implement interventions and provide resources for improving maternal knowledge.
4. Health Professionals: Provide training and support to mothers, ensuring they have accurate information about danger signs.
Cost Items for Planning Recommendations:
1. Development and printing of educational materials: Includes the cost of designing and producing brochures, posters, and other educational resources.
2. Training programs: Budget for organizing training sessions for health professionals and health extension workers.
3. Communication campaigns: Allocate funds for conducting awareness campaigns through various media channels.
4. Health visits: Consider the cost of organizing and facilitating health visits for mothers, including transportation and logistics.
5. Monitoring and evaluation: Set aside a budget for monitoring and evaluating the effectiveness of interventions and making necessary adjustments.
Please note that the provided cost items are general suggestions and may vary depending on the specific context and resources available.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong, but there are some areas for improvement. The study design is community-based and cross-sectional, which provides a good snapshot of the knowledge of mothers in Central Tigrai, Ethiopia. The sample size was determined using a formula and appropriate statistical methods were used for data analysis. However, there are some limitations to consider. The study only focuses on mothers who had ever had sick under-five children with a history of common childhood illness in 2017, which may limit the generalizability of the findings. Additionally, the data collection tools were suitably translated, but it is unclear how the validity and reliability of the questionnaire were assessed. To improve the strength of the evidence, future studies could consider using a larger and more diverse sample, include a control group for comparison, and conduct a validation study of the data collection tools.

Introduction Globally, a large number of under-five deaths have occurred from preventable and treatable common childhood illnesses. Therefore, early identification of general danger signs of common childhood illnesses and adhering to appropriate treatment helps to reduce morbidity and mortality. This study aimed to assess the knowledge of mothers and associated factors on general danger signs of common childhood illnesses of under-five children in Central Tigrai, Ethiopia. Methods A community-based cross-sectional study design was employed from February to March 2017. A total of 416 study participants were finally enrolled in the study using simple random sampling technique. A pretested and structured interviewer-based questionnaire was used. Data were entered, coded and analysed using SPSS 22.0. Multivariable logistic regression was used to control the effect of confounders. Results In this study, 44.7% of the mothers had good knowledge of the general danger signs of common childhood illnesses. Mothers’ educational status (AOR=1.93, 95%CI=1.09-3.44, p=0.025), occupation of mothers (AOR=5.94, 95%CI=3.17-11.12, p≤0.001), childbirth order (AOR=1.85, 95%CI=1.00-3.40, p=0.005) and source of information (AOR=2.19, 95%CI=1.23-3.87, p=0.007) were significantly associated with knowledge of mothers on general danger signs of common childhood illnesses. Conclusions Maternal knowledge of general danger signs of common childhood illnesses was low. Therefore, intervention modalities focusing on improving the educational level, behavioural change communication activities, and access of mothers to health visits are needed.

The study was held in Adwa town, Tigrai, Ethiopia, which is found in Central Tigrai Regional state at a distance of 977 km away from Addis Ababa (the capital city of Ethiopia) and 190 kms from Mekelle (the capital city of Tigrai). A community-based cross-sectional study design was employed among mothers who had ever had sick under-five children with a history of common childhood illness in 2017. A total of 418 mothers who had ever had sick under-five children with a history of common childhood illness were included in the study. The sample size was determined using single population proportion formula, by using 95% confidence level, 5% margin of error, 10% of the non-response rate and considering 55.4% proportion of mothers’ health-seeking behaviour for common childhood illnesses.13 The sample size was allocated to the five kebeles of Adwa town by proportional allocation. The list of households of the under-five child with a common childhood illness six months prior to the survey was identified by health extension workers working in each kebeles and the sampling frame was made from that; by using simple random sampling method (lottery method), the sample was selected. Interviewer based structured questionnaires were used to collect the data. Questions were suitably translated to the local language, Tigrigna and then back to English for data entry. For data collection and supervision. five diploma nurses working outside the study area and three BSc health professionals working in Adwa town were recruited accordingly. The data collectors were trained for two days on information about data collection tools, techniques, approaching participants, ethical issues and advantage of collecting the actual data. A pre-test was conducted among the 42 (10%) mothers from Axum, a place near to Adwa with similar study population, two weeks before the actual data collection period, for its clarity, understandability and completeness, and individuals who participated in the pre-test were excluded from the actual data collection. After that, the necessary corrections and modifications were made. Confidentiality of the participants was kept throughout the study and the supervisors were controlling the data collection process and checked the data collection tool. At the end of each day, questionnaires were reviewed and cross-checked for their completeness, accuracy and logical consistency by the principal investigator and corrective measures were undertaken. General danger signs: according to WHO standard categorized as: unable to breastfeed, unable to drink or eat, vomiting everything, convulsion, and lethargic or unconsciousness.2 Good knowledge on general danger signs: referred for the mothers who mentioned mean score and above of the knowledge questions (≥3 general danger signs).14-16 Poor knowledge on general danger signs: referred for the mothers who mentioned below the mean score of the knowledge questions (<3 general danger signs).14-16 Ever sick children with common childhood illnesses: the children had become ill with ARI, diarrhea and fever 6 months prior to the study. Data were coded, entered and analysed using Statistical Package for Social Science (SPSS) version 22.0 software (IBM Corp., Armonk, NY, USA). Descriptive analysis was done by using frequencies and percentages. Bar graph and pie chart were used to describe the study participants in relation to relevant variables and association between independent and dependent variables were assessed using crude odds ratio with 95% confidence interval with respect to the p-value. If significant variables (p<0.2) were detected at the bivariate logistic regression level they were entered to multivariable logistic regression. The model of fitness was checked by Hosmer and Lemeshow test and its p-value was 0.917. Multicolinearity was checked using the Variance Inflation Factor (VIF) and those with VIF greater than 10 were excluded from the model. Finally, adjusted odds ratios (AOR) with 95% confidence interval (CI) and p-value less than 0.05 were considered as a significant association. Ethical approval was obtained from a research ethics committee of the College of Health Sciences of Mekelle University with a reference number of 0906/2017. Official letter of cooperation was written to Tigrai Regional Health Bureau from the Department of Nursing. Support letter was obtained from the Tigrai Regional Health Bureau and Adwa Woreda health office and respective selected kebeles before field activities. Informed verbal consent was obtained from study participants. Confidentiality of results among the study participants was kept.

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Based on the information provided, here are some potential innovations that could be used to improve access to maternal health:

1. Mobile Health (mHealth) Applications: Develop and implement mobile applications that provide information on general danger signs of common childhood illnesses. These applications can be easily accessed by mothers, providing them with knowledge and guidance on when to seek medical help.

2. Community Health Workers: Train and deploy community health workers to educate mothers on general danger signs of common childhood illnesses. These workers can visit households, conduct health education sessions, and provide guidance on when to seek medical care.

3. Telemedicine: Establish telemedicine services that allow mothers to consult with healthcare professionals remotely. This can help overcome geographical barriers and provide timely advice and guidance on general danger signs of common childhood illnesses.

4. Health Education Campaigns: Conduct targeted health education campaigns to raise awareness among mothers about the importance of early identification of general danger signs of common childhood illnesses. These campaigns can utilize various media channels, such as radio, television, and social media, to reach a wide audience.

5. Maternal Health Visits: Increase the frequency of maternal health visits to ensure regular check-ups and provide mothers with information on general danger signs of common childhood illnesses. These visits can also serve as an opportunity to address any concerns or questions that mothers may have.

6. Partnerships with Non-Governmental Organizations (NGOs): Collaborate with NGOs to implement programs that focus on improving access to maternal health services. These programs can include training sessions, awareness campaigns, and the provision of resources to support mothers in identifying general danger signs of common childhood illnesses.

It is important to note that these recommendations are based on the information provided and may need to be tailored to the specific context and needs of the community in Central Tigrai, Ethiopia.
AI Innovations Description
Based on the study conducted in Central Tigrai, Ethiopia, the following recommendation can be used to develop an innovation to improve access to maternal health:

1. Improve educational level: The study found that maternal knowledge of general danger signs of common childhood illnesses was low. Therefore, it is recommended to focus on improving the educational level of mothers. This can be done through targeted educational programs, workshops, and training sessions that provide information on common childhood illnesses and their danger signs.

2. Behavioral change communication activities: In order to improve access to maternal health, it is important to promote behavioral change among mothers. This can be achieved through communication activities that emphasize the importance of early identification of danger signs and prompt treatment seeking. These activities can include community awareness campaigns, health education sessions, and the use of local media channels.

3. Increase access to health visits: The study found that the source of information was significantly associated with maternal knowledge of danger signs. Therefore, it is crucial to increase access to health visits for mothers. This can be done by improving the availability and accessibility of healthcare facilities, especially in rural areas. Mobile clinics, outreach programs, and community health workers can also be utilized to reach mothers who have limited access to healthcare services.

By implementing these recommendations, it is possible to develop an innovation that improves access to maternal health by increasing maternal knowledge, promoting behavioral change, and enhancing access to healthcare services.
AI Innovations Methodology
Based on the provided description, here are some potential recommendations to improve access to maternal health:

1. Enhance educational programs: Develop and implement educational programs that focus on improving maternal knowledge of general danger signs of common childhood illnesses. These programs can be conducted in healthcare facilities, community centers, and through outreach activities.

2. Strengthen behavioral change communication: Implement behavior change communication activities that aim to promote positive health-seeking behaviors among mothers. This can include raising awareness about the importance of seeking timely and appropriate treatment for common childhood illnesses.

3. Improve access to healthcare visits: Increase access to healthcare visits for mothers by expanding the availability of healthcare facilities, particularly in rural areas. This can involve establishing mobile clinics, increasing the number of healthcare professionals, and improving transportation infrastructure.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could be developed as follows:

1. Define indicators: Identify key indicators that measure access to maternal health, such as the percentage of mothers with knowledge of general danger signs, the percentage of mothers seeking timely treatment for common childhood illnesses, and the availability of healthcare facilities in the target area.

2. Collect baseline data: Conduct a survey or data collection process to gather baseline data on the identified indicators. This can involve interviewing mothers, conducting facility assessments, and analyzing existing data sources.

3. Implement interventions: Implement the recommended interventions, such as educational programs, behavior change communication activities, and improvements in healthcare access. Ensure that these interventions are implemented consistently and monitored closely.

4. Monitor and evaluate: Continuously monitor the progress and impact of the interventions. Collect data on the indicators identified in step 1 at regular intervals to assess any changes or improvements. This can involve conducting follow-up surveys, analyzing healthcare facility records, and conducting interviews or focus groups.

5. Analyze and interpret data: Analyze the collected data to determine the impact of the interventions on access to maternal health. Compare the baseline data with the data collected after the interventions to identify any changes or improvements. Use statistical methods, such as regression analysis or chi-square tests, to assess the significance of the findings.

6. Draw conclusions and make recommendations: Based on the analysis of the data, draw conclusions about the impact of the interventions on improving access to maternal health. Identify any gaps or areas for improvement and make recommendations for future interventions or strategies.

7. Communicate findings: Present the findings of the impact assessment to relevant stakeholders, such as healthcare providers, policymakers, and community members. Use clear and concise language to effectively communicate the results and recommendations.

By following this methodology, it is possible to simulate the impact of the recommended interventions on improving access to maternal health and make evidence-based decisions for future interventions.


Statistics:
Citations: 1
Identifiers:
DOI: 10.18683/germs.2019.1175
Research Areas:
Community Interventions, Health System and Policy, Infectious Diseases, Maternal Access, Maternal and Child Health, Social Determinants
Study Countries:
Ethiopia
Study Design:
Case-Control Study, Cross Sectional Study, Grounded Theory, randomised-control-trial
Study Approach:
Quantitative
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