Under-five Children In Rural Areas Research Articles

Water, sanitation, and hygiene (WASH) practices of mothers and the health status of under-five children: a study from Rural Nayagarh, Odisha

ABSTRACT The objective of this study was to assess water, sanitation, and hygiene (WASH) practices of mothers with under-five children in rural pockets of the Nayagarh district, Odisha and examine how those practices are associated with the health status of children. A cross-sectional household survey was carried out with 370 participants having under-five children in rural pockets of the Nayagarh district, Odisha. A multistage sampling strategy was adopted. Participants were interviewed using a pre-tested structured schedule. Household information was analysed using descriptive statistics; logistic regression models were used to determine the association between mothers’ handwashing practices and the health status of their under-five children. Nearly 74.9% of the households in the sample earned less than 40,000 Indian rupees ($481) annually. Nearly 73% of mothers threw the childrens' faecal waste into drains and open garbage. Diarrhoea was strongly associated with mothers who did not encourage their children to wash their hands (p = 0.007). The frequency of mothers' handwashing before feeding was associated with childrens' episodes of fever, common cold, and cough (p = 0.045). A set of targeted interventions, such as health education and socio-behavioural changes, is needed to address significant WASH factors associated with the health of under-five children in rural areas.

Socio-demography, nutritional status, age-appropriate immunization coverage and morbidity among under-five children in rural Maharashtra

Background: Morbidities among under-five children in rural areas is a major public health problem. This study was conducted to assess the nutritional status, age-appropriate immunization coverage, personal hygiene and morbidity pattern among under-5 children and their socio-demographic determinates in rural slum dwellings. Methods: A community based cross sectional study was conducted in rural area of Maharashtra using purposive sampling technique. The survey was done by using predesigned and pretested proforma along with recording of socio-demographic factors, anthropometric measurements, immunization status and clinical examination of the study subjects. Results: The study included 86 under-5 children from a rural slum dwelling. 16 (18.60%) subjects were underweighted, 35 (40.70%) were stunted and 14 (16.28%) were wasted. 04 (04.65%) and 02 (02.33%) subjects were MAM and SAM respectively. 35 (40.70%) subjects were morbid. 20 (23.26%) subjects were suffering from louse infestation of which 07 (14.58%) were boys and 13 (34.21%) were girls (p<0.05). 17 (19.77%) subjects were suffering from dental caries. 12 (13.95%) subjects were suffering from skin diseases. 23 (26.74%) subjects were suffering from oral health problems. All subjects’ personal hygiene was poor. 72 (83.72%) subjects were age-appropriate fully immunized. The association between monthly family income and presence of stunting among the subjects is statistically significant (p<0.05). Conclusions: Underweight, stunting, wasting, MAM, SAM, louse infestation, skin diseases, dental caries, oral health problems and poor immunization coverage are found to be major health problems among the under-five children in rural areas. Poor personal hygiene of under-5 children is also a major issue. Capacity building of parents for early health seeking and strengthening of primary health care services is essential to act timely in managing these morbidities.

Assessment of Prevalence of Malnutrition among Under-Five Children in Rural Area of Haldwani

Background: Malnutrition in children is global issue that may have both short- and long-term irreversible negative health consequences.Objectives: To determine the prevalence of under-nutrition among the under-five children inrural area of Haldwani. Material and methods: Community-based cross-sectional study.Results: Four-hundred children were examined. The prevalence of undernutrition among children was depicted as underweight, stunting and wasting was 7.75%, 9.25% and 4% respectivel

Drinking water contamination potential and associated factors among households with under-five children in rural areas of Dessie Zuria District, Northeast Ethiopia.

More than half of the 700 million people worldwide who lack access to a safe water supply live in sub-Saharan Africa, including Ethiopia. Globally, approximately 2 billion people use drinking water sources that are contaminated with fecal matter. However, little is known about the relationship between fecal coliforms and determinants in drinking water. Therefore, the objective of this study was to investigate the potential for contamination of drinking water and its associated factors in households with children under 5 years of age in Dessie Zuria district in northeastern Ethiopia. The water laboratory was conducted based on the American Public Health Association guidelines for water and wastewater assessment using a membrane filtration technique. A structured and pre-tested questionnaire was used to identify factors associated with the potential for contamination of drinking water in 412 selected households. A binary logistic regression analysis was performed to determine the factors associated with the presence or absence of fecal coliforms in drinking water, with a 95% confidence interval (CI) and a value of p ≤ 0.05. The overall goodness of the model was tested using the Hosmer-Lemeshow test, and the model was fit. A total of 241 (58.5%) households relied on unimproved water supply sources. In addition, approximately two-thirds 272 (66.0%) of the household water samples were positive for fecal coliform bacteria. Water storage duration ≥3 days (AOR = 4.632; 95% CI: 1.529-14.034), dipping method of water withdrawal from a water storage tank (AOR = 4.377; 95% CI: 1.382-7.171), uncovered water storage tank at control (AOR = 5.700; 95% CI: 2.017-31.189), lack of home-based water treatment (AOR = 4.822; 95% CI: 1.730-13.442), and unsafe household liquid waste disposal methods (AOR = 3.066; 95% CI: 1.706-8.735) were factors significantly associated with the presence of fecal contamination in drinking water. Fecal contamination of water was high. The duration of water storage, the method of water withdrawal from the storage container, covering of the water storage container, the presence of home-based water treatment, and the method of liquid waste disposal were factors for fecal contamination in drinking water. Therefore, health professionals should continuously educate the public on proper water use and water quality assessment.

Prevalence of undernutrition and associated risk factors among under five children in rural Haldwani

Background: The foundation of any nation is children. Malnutrition in children is global issue that may have both short- and long-term irreversible negative health consequences and thus associated with morbidity and mortality. Aims and Objectives: The study aims to determine the prevalence and associated risk factors of under-nutrition among under-five children in rural area of Haldwani. Materials and Methods: A community-based cross-sectional study conducted on Four hundred children residing in the rural field practice area of the Department of Community Medicine, Government Medical College, Haldwani. Results: The prevalence of underweight, stunting, and wasting was 7.75%, 9.25%, and 4%, respectively among under five children. The risk factors found significantly associated with undernutrition and sociodemographic profile were family size, parent’s education, mother’s occupation, and the socioeconomic class. The maternal factors found significantly associated with undernutrition were intake of iron folic acid tablets during antenatal care and postnatal care period, duration of pregnancy, site of delivery. Prelacteal, colostrum given, exclusive breastfeeding, and age of introducing complementary feeding and occurrence of recurrent diarrhea, recurrent acute respiratory infection, and worm infestation were child characteristics and medical illness found significantly associated with undernutrition. Conclusion: In this study, 17.5% of children were found undernourished. Factors determining undernourishment were parents literacy, social class, type and size of family, iron folic acid taken during pregnancy, feeding practices, immunization status, history of recurrent diarrhea, and other infections in the past 1 year.

Treatment-Seeking Behaviors of Families for under Five Children in Field Practice Area of Jawaharlal Nehru Medical College, Wardha

Context: Globally, India had the largest population of under-five (127 million), and the greatest number of under five deaths (2.1 million) in 2006. Nearly about 2 million of cases of diarrhea occur annually in India. An average Indian child below 5 years of age can have 2–3 episodes of diarrhea. It contributes to nearly 2.1 million of the global burden of 9.7 million under five deaths, which is the highest for any nation in the world. The Millennium Development Goal 4 aimed at reducing under-five mortality by two-third till year 2015 which remained unachieved and sustainable development goal 3 aims to ensure healthy lives and promote well-being for all at all ages including under-five children by the year 2030. The health and treatment-seeking behavior of parents and caregivers has direct reflection over child survival statistics of India. The present study has been conducted to study the determinants of treatment-seeking behavior of families for illness of under-five children in the field practice area of Jawaharlal Nehru Medical College (JNMC), Sawangi, Wardha, Maharashtra, India. Aims: A study on the treatment-seeking behaviors of families for illnesses of under-five children in field practice area of JNMC, Wardha, Maharashtra, India. Objectives: The objective of this study is to know the treatment-seeking behaviors of families for under-five children in rural areas. Materials and Methods: This study was carried out in the field practice area of community medicine JNMC, Sawangi Wardha, Maharashtra, India. The present study was carried out in the adopted villages from the field practice area of Wardha district by the JNMC. The present study was a community-based, cross-sectional study, and the study period was 6 months (i.e., from July 2019 to December 2019). The study participants comprised of the caregivers of children under-5 years of age and including mothers and other family members who were primarily responsible for attending the child's health. All children in the age group of 0 to 5 years from the study area were identified for the same (from Anganwadi's in the villages). The study participants, i.e., parents who were ready to participate in the study by signing the written consent were included in the study. Statistical Analysis Used: A predesigned and prestructured questionnaire was prepared and implemented for data collection. Results: The results showed that most of the under-five children were in the age group of 2–3 years. Most of the under-five children were having itching on skin followed by fever and diarrhea. Most of the parents took their under-five children to ANM's or the government hospital situated at their place. Conclusions: The present study concludes that treatment-seeking practices among parents for under-five children in the adopted villages of medical college are satisfactory in terms of qualified treatment provider and compliance to the treatment.

Socio-demographic and Morbidity Pattern among Under-Five Children in Rural Areas of Adilabad District of Telangana, India

Introduction: The health and well-being among children is an important parameter for the measurement of the progress of a nation, which is also most precious asset in the community for socio-economic development in long run. It is not wise to neglect the health rights of the children in the process of nation building. The under-five children are the most vulnerable group in a society in which there is lack of guarantee for adequate nutrition and social protection. The lack of essential health services ultimately leads to childhood diseases like diarrhoea, respiratory infections, and measles in various parts of India. Aim: To understand the socio-demographic and morbidity pattern among the children of under five years in a district of Telangana state, India. Materials and Methods: A cross-sectional study was undertaken by interviewing mothers with the help of a predesigned and pretested questionnaire to understand the morbidity pattern of children under five years in the rural areas of Adilabad district, Telangana, India. The study was conducted in March 2015 in 30 villages. The study assessed various determinates of morbidity by applying scientific principles. The sample size was calculated as 210. The data was analysed by using MS Excel spread sheet and Statistical Package for the Social Sciences (SPSS) software to understand the morbidity pattern. Descriptive statistical tests were done to find out the results. Results: The result confirms that 154 (73.33%) of the children under five years have several forms of morbidities. The most common morbidity was Acute Respiratory Infection (ARI) (25.71%), which is followed by worm infestation (8.09%), diarrhoea (20%), fever (7.61%), scabies (7.61%), asthma (2.3%) and seizure (fits) (1.9%) in last three months from the data collection. All these diseases are prevalent in rural areas of high concern due to the impeding morbidity and mortality. Conclusion: The ARI and diarrhoea were found to be the cause of concern among under-five children, which dominate the morbidity pattern. The factors responsible with such precarious situation were deeply entrenched conditions like illiteracy, poor socio-economic conditions, poor environmental sanitation, and increased birth order among the population.

Effectiveness of planned teaching programme regarding worm infestation on knowledge among mothers of under-five children in rural area of Lucknow district

Background: According to the World Health Organization 241 million children between the ages of 1 and 14 years are at high risk of parasitic intestinal worms in India. As per the first-post news updated November 24, 2019, At least 241 million children below the age of 14 years are at high risk of getting stomach worms in India. The study was conducted with the objective to assess the level of knowledge and effectiveness of planned teaching programme on knowledge regarding worm infestation among the mothers of under-five children.Methods: The experimental pre-test-post-test control group design used and probability random sampling technique was adapted to select 92 mothers for both groups. Tool was used semi-structured knowledge questionnaire and planned teaching programme was implemented only on experimental group.Results: The results revealed that in experimental group post-test mean and SD score i.e. (16±3.56) was significantly higher the pre-test score i.e. (8.26±3.79) and compared the ‘t’ value, calculated ‘t’ value was (3.76) at the level of significance (0.05) and tabulated with 45 degree of freedom i.e. (2.01). So, it showed that the planned teaching programme regarding worm infestation among the mothers of under-five children in rural area was found effective.Conclusions: The present study assessed the knowledge among mothers of under-five children regarding worm infestation and found that mothers had poor knowledge related to worm infestation. After the planned teaching programme on worm infestation there was significant improvement on knowledge of the mothers of under-five children regarding worm infestation in experimental group.

Determinants of acute respiratory infection (ARI) among under-five children in rural areas of Legambo District, South Wollo Zone, Ethiopia: A matched case–control study

BackgroundAcute respiratory infection (ARI) leads to morbidity and mortality among under-fivechildren in developing countries, especially in rural settings. ARI ranks among the top 10 diseases in under-five children in Legambo District, South Wollo Zone, Ethiopia. The aim of this study was to evaluate determinant factors for ARI in Legambo District in 2019. Materials and methodsA community-based matched case–control study was conducted, involving 139 cases and 278 controls under 5 years of age, from mid-January to mid-February 2019. Data were collected using a structured questionnaire. Bivariate and multivariable conditional logistic regression analyses were performed. From the multivariable conditional logistic regression analysis, variables with a significance level of p < 0.05 were taken as significantly associated with ARI among under-five children. ResultARI among children under 5 years of age was significantly associated with age of the mother/caregiver being ≥35 years, occupation of mother/caregiver being housewife, the family being of medium wealth status, the type of stove used in the house, carrying the child while preparing food, absence of windows in the house, and nutritional status of the child. ConclusionThe occurrence of ARI could be reduced by improving economic status, stove use, and nutrition of children, and by increasing community awareness regarding indoor air pollution and ventilation.

Prediction Model and Scoring System in Prevention and Control of Stunting Problems in Under Five-Year-Olds in Indonesia

Prevalence of stunting in Indonesia is a cause for concern. We used IFLS 2007 as secondary data in the cross-sectional study to develop a problem-solving and prevention model of stunting. The study was conducted in 2016 to predict a model from the characteristics, parents, and health care of the child. We recruited 3589 children under-five years from IFLS 2007 data as samples. The inclusion criteria are 1-5 years old children from 15-49 years old pregnant women, living with biological parents, available data of birth weight and gestational age, and do not have chronic disease. We used multiple logistic regression for modeling, and Receiver Operation Characteristic (ROC) Curve as a diagnostic test. We found that 39.5% of children under-five have stunting. Stunting protective factors are: prevention of LBW (Low Birth Weight) in infant, limitation of number of children by three, improved parenting for the boys, prevention of young-age pregnancy and stunting in the female adolescent. Other factors are completing immunization, improving maternal education and the health services of under-five children in rural areas, and improving Fe consumption for pregnant mothers. The model was able to prevent and delay the stunting in toddler by 64%, with 61.9% sensitivity and 60.9% specificity, and AUROC 65.5%. It is necessary to counsel the pregnant women with a low height and young-age pregnancy as a high risk, as well as management of the infant with LBW to prevent stunting.

Study on Knowledge,Attitude and Practices concerning Immunization of under-five children in rural areas of Nalgonda

Study on Knowledge,Attitude and Practices concerning Immunization of under-five children in rural areas of Nalgonda

Diarrhea Prevalence and Sociodemographic Factors among Under-Five Children in Rural Areas of North Gondar Zone, Northwest Ethiopia.

Background Diarrheal disease remains one of the principal causes of morbidity and mortality in infants and children in developing countries, including Ethiopia. Risk factors for diarrhea vary by settings and have important implications for developing intervention strategies to reduce the burden of the disease. Thus, the aim of this study was to assess diarrhea prevalence and sociodemographic factors among under-five children in rural areas of North Gondar Zone. Methods A community-based cross-sectional study was conducted from April to June 2016 among 736 randomly selected households with one child under five years old. A structured questionnaire was used for collecting information on sociodemographic characteristics and diarrheal occurrence. Data was analyzed using SPSS version 20. The bivariate and multivariable logistic regression analysis were used to determine the association between risk factors and diarrheal occurrence, and a p value < 0.05 was taken as statistically significant. Results A total of 736 under-five children and their respondents were enrolled during the study period. Almost all respondents were biological mothers 96.4% (709/736), married 94.2% (693/736), and house wives 86% (632/736). The overall prevalence of diarrheal disease among under-five children was 22.1% (163/743). Of these, children with age group of less than one year old, 7.7 % (57/736), were commonly infected with diarrheal diseases. Children less than or equal to one year [AOR=1.82, 95% CI= (1.39, 4.63)], guardians [AOR=4.37, 95% CI= (1.73, 11.1)], and children with no breast feeding practice [AOR=3.13, 95% CI= (1.62, 6.03)] were the major risk factors for the occurrence of diarrhea. Conclusion Childhood diarrhea remains an important health concern in the study area. Occurrence of diarrhea was statistically associated with child age less than or equal to one year, educational status of mother/guardians, and breast feeding. To minimize the magnitude childhood diarrhea, various designing and implementing strategies, such as health education, child care, breast feeding, and weaning practice, integrated with the existing national health extension are quite essential.

The Risk Factors of Underweight Among Under-Five Children in Rural Area of Central Java, Indonesia

The Risk Factors of Underweight Among Under-Five Children in Rural Area of Central Java, Indonesia

Communication for behavioural impact in enhancing utilization of insecticide-treated bed nets among mothers of under-five children in rural North Sudan: an experimental study.

BackgroundMalaria is the leading cause of morbidity and mortality in Sudan. The entire population is at risk of contracting malaria to different levels. This study aimed to assess the effectiveness of communication for behavioural impact (COMBI) strategy in enhancing the utilization of long-lasting insecticidal nets (LLINs) among mothers of under-five children in rural areas.MethodsA randomized community trial was conducted in rural area of Kosti locality, White Nile State, Sudan, among mothers of under-five children, from January 2013 to February 2014. A total of 761 mothers from 12 villages were randomly selected, 412 mothers from intervention villages and 349 were from comparison villages.ResultsThe knowledge of mothers, in intervention villages, about malaria vector, personal protective measures (PPM) against malaria, and efficacy of LLINs was significantly increased from 86.9 to 97.3 %; 45.9 to 92 % and 77.7 to 96.1 % respectively. Knowledge about usefulness of PPM, types of mosquito nets and efficacy of LLINs was significantly higher in intervention villages compared to comparison villages (p < 0.05), (η2 = 0.64). Mothers in intervention villages increasingly perceived, post-intervention, that malaria was a serious disease (99.3 %), a preventable disease (98.8 %) and also LLINs as an effective intervention in malaria prevention (92.2 %). This resulted in an increase in the utilization rate of LLINs from 19.2 to 82.8 % in intervention villages compared to comparison villages (p < 0.05) [OR = 4.6, 95 %, CI = (3.72–5.72)], (η2 = 0.64). The average of mothers’ knowledge about malaria was increased by 64 % (η2 = 0.64), the use of LLINs was increased by 79 % (η2 = 0.79) and a positive attitude towards malaria was 2.25 times higher in intervention villages than among mothers in the comparison villages.ConclusionsThese results established the usefulness of COMBI strategy for increasing awareness about malaria, developing a positive perception towards malaria prevention and, increasing the utilization of LLINs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1551-8) contains supplementary material, which is available to authorized users.

Knowledge and perception regarding childhood pneumonia among mothers of under-five children in rural areas of Udupi Taluk, Karnataka: A cross-sectional study

Background: A large number of children die due to pneumonia making it the single largest infectious cause of death more than AIDS, measles, and malaria combined. In India, acute respiratory infection is a major public health problem, especially for the age group of 0–5 years which contributes to 15–30% of deaths falling under this age group and most of these deaths are preventable. Objective: To assess the level of knowledge and perception regarding childhood pneumonia among mothers of under-five children. Materials and Methods: A cross-sectional study was conducted among 460 mothers of under-five children. Interviewer-administered structured questionnaire was used for data collection and the sampling technique used was three-stage cluster sampling. The questionnaire was divided into three sections as socio-demographic profile, level of knowledge, and level of perception. Results: The study found that mothers were predominantly secondary school graduates (32.6%) out of which, 93.7% were homemakers, 41.3% mothers had fair knowledge, and 41.5% had fair perception about pneumonia. Age and education level of mothers had a significant association with the knowledge as well as with perception. There was a significant association between level of knowledge and perception of childhood pneumonia among these mothers. Conclusion: Overall, mothers had fair knowledge and fair perception of childhood pneumonia. The lack of knowledge about simple signs and symptoms and factors related to pneumonia needs to be addressed.

Determinants of under-five mortality in rural and urban Kenya

The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.