A study to assess the knowledge and practice of mothers about oral rehydration therapy in Fanda and Bhaisakhedi villages of Bhopal.
Acute diarrheal disease with its associated dehydration has remained a challenging problem to the medical profession and the community in the third world countries especially in the children aged below five years. (4,5,6,7) Since 1979 Oral Rehydration Therapy became the keystone approach to tackle the dehydration caused by diarrhea and from then onwards there was a steady decline in death toll caused by Diarrheal diseases. (8,9)
However the use of oral rehydration solution largely depends, on the level of mother's knowledge and her attitude towards its use. The present study assesses the level of knowledge and attitude of the mothers residing in a rural area towards the use of oral rehydration solution during diarrheal illness.
This study was carried out with an objective of assessing the knowledge, attitude and practice of mothers having children less than 5 years regarding the use of ORS in management of diarrhea in a rural area.
METHODOLOGY: This was a cross-sectional descriptive study carried out among families who reside in Fanda and Bhaisakhedi villages of Bhopal in central India during a period of 3 months to assess the knowledge and attitude regarding role of ORS in management of diarrhea. A total of 200 mothers were willing to participate in the study and they were enrolled in this study by using convenience sampling with inclusion criteria being mothers having children less than 5 years of age. In present study, data was collected by using a preformed and pretested questionnaire. The knowledge and attitude of the mothers pertaining to ORS was defined as awareness about the availability and preparation of ORS and its use in the management of diarrheal diseases. The questionnaire included questions concerning the knowledge about ORS, method of preparation and source of information about ORS and also the role of ORS in the management of diarrheal diseases. Data was also collected for socio demographic characteristics such as age, occupation, literacy. Socioeconomic status was based on modified Kuppuswamy scale for urban area.
RESULTS: As shown in the table-1 Most of the mothers i.e. 58%(29) were belonging to the age group 20-24 years and most of them were house wives i.e. 92% and almost 1/5th of them had completed their education up to Higher secondary i.e. 22% followed by another 1/5th i.e. 20% with their education status up to high school. 78% of the mothers who participated in the study were belonging to Upper Lower Class according to Kuppuswamy Classification of SES.
As shown in the pie chart (figure-1) Anganwadi was the main source of information about ORS to the mothers contributing to 52%, followed by Doctors who were the second most important source of information about ORS to the mothers contributing to 30%, in 12% of the mothers Television was the source of information and only 6% of the mothers sought information from their neighbors.
Bar diagram (Figure-2) shows that most of the mothers i.e. 54% were of the view that ORS during diarrhea decreases water loss, 22% of the mothers said that ORS improves diarrhea and only 8% said that ORS replenishes electrolytes during diarrhea. It was also observed that 24% of the mothers were not aware about why ORS is used during diarrhea.
As shown in the pie chart (Figure-3) more than half of the mothers i.e. 52%(26) were not aware about the home made ORS, followed by 44%(22) mothers with a good knowledge about homemade ORS who told that it is a mixture of sugar and salt solution and only 4%(2) told that even daal water can be used as ORS.
As shown in the bar diagram (Figure-4) 77% of the mothers directly consulted the doctors when their children suffered from diarrhea hence they did not use ORS as the first remedy this was followed by a reason that the child is very small for the usage of ORS hence 15 % of the mothers did not use ORS and only 8% of the mothers said that their children did not want to drink ORS.
As shown in the table-2 out of total 200 mothers, 92 (48%) of the mothers used ORS during diarhhoeal episodes, 49 (24.5%) mothers had knowledge about correct method of preparation of ORS and 35 (17.5%) of them were knowing about the duration of ORS therapy. 20 (10%) of them were knowing about the harm of giving too much ORS and 82 (41%) of them said that if vomiting continues then ORS has to be stopped.
DISCUSSION: ORS is the discovery of 20th millennium to reduce the morbidity and mortality caused by diarrheal diseases but it is still far from being highly effective especially in developing countries due to lack of awareness about proper use of oral rehydration solution for management of diarrheal episodes.
In present study, although 82% of the mothers were educated 54% percent of the mothers were aware that ORS during diarrhoea decreases water loss while 24% of the mothers were not even aware about the reason of ORS usage during diarrhoea. Only 28.6% of the mothers were knowing about the correct method of preparation of ORS and only 20.7% of mothers were knowing about the duration of ORS therapy.
The results are somewhat different from the study conducted by Mahor G.R. in an Urban Slum area of Bhopal (4) who found that even though 75% of the mothers were educated 94.5% of them were aware about the reason of ORS usage during diarrhoea only 5.5% of them were not aware about the reason of ORS usage during diarrhoea and 39% of them were knowing about the correct preparation of ORS. In a similar study conducted by Rasania S.K.et all in few urban slums of Delhi (5) it was observed that the mothers considered ORS as other form of medication and not necessarily a replacement of body fluid.
Several studies conducted on the effectiveness of electronic and mass media have proven that awareness level of people about the use of oral rehydration therapy can be improved. Mothers regularly exposed to electronic mass media are much more likely to know about ORT efficiently.
CONCLUSION: In this study the knowledge of the mothers about the method of usage of ORS in managing diarrheal episodes was found to be insufficient. Although many mothers were aware about the fact that ORS is useful but most of them were not aware about its proper method of preparation and usage. This knowledge gap needs to be improved by the measures that are directed towards disseminating the knowledge, changing the negative attitudes and encouraging the better practices about usage of ORS in the mothers for the effective management of diarrhea.
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(3.) Govt. of India (2014), National Health Profile 2013 (Jan-Dec.), DGHS, Central Bureau of Health Intelligence, Ministry of Health and Family Welfare, New Delhi.
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(5.) Rasania SK, Singh D, Pathi S, Matta S, Singh S. Knowledge and attitude of mothers about oral rehydration solution in few urban slums of Delhi. Health Popul Perspect Issues. 2005; 28(2): 100-7.
(6.) Kadam DM, Hadaye R, Pandit D. Knowledge and practices regarding oral rehydration therapy among mothers in rural area of Vasind, India. Nepal Med Coll J. 2012; 15(2): 110-2.
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Jeewan Singh Meena , Vishwanath Arutagi 
[1.] Jeewan Singh Meena
[2.] Vishwanath Arutagi
PARTICULARS OF CONTRIBUTORS:
[1.] Assistant Professor, Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh.
[2.] Post Graduate Resident, Department of Community Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh.
FINANCIAL OR OTHER COMPETING INTERESTS: None
NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Vishwanath Arutagi, Department of Community Medicine, Gandhi Medical College, Bhopal-462001, Madhya Pradesh.
Date of Submission: 04/09/2015. Date of Peer Review: 05/09/2015. Date of Acceptance: 15/09/2015. Date of Publishing: 21/09/2015.
Table-1: Socio Demographic Profile of the Mothers. Variable Frequency Percentage Mothers' age 20-24 year 96 5$% 25-29 year 72 36% 30-34 year 12 6% Occupation Housewife 184 92% self employed 12 6% Govt, employed 4 2% Education Illiterate 36 1S% Primary 32 16% Middle 36 18% High School 40 20% Higher secondary 44 22% Graduate 4 2% Postgraduate 8 4% Socioeconomic Status Upper Middle 16 S% lower Middle 20 10% Upper Lower 148 74% Lower 16 S% Table-2: showing the knowledge of mothers about ORS in relation to their education status Educational status of mother Illiterate Primary Middle Used ORS 5(2.5%) 16(8%) 18 (9%) during diarrhea Correct 2(1%) 9(4.5%) 11(5.5%) Preparation of ORS Duration of 1(0.5%) 4(2%) 9(4.5%) ORS Therapy Harm of giving 0 2(1%) 5(2.5%) too much ORS Stop ORS, if 3(1.5%) 11(5.5%) 25(12.5%) vomiting continues Educational Total status of mother (n = 200) Above Used ORS 53 (26.5%) 96(48%) during diarrhea Correct 27(13.5%) 49(24.5%) Preparation of ORS Duration of 21(10.5%) 35(17.5%) ORS Therapy Harm of giving 13(6.5%) 20(10%) too much ORS Stop ORS, if 43(21.5%) 82(41%) vomiting continues Fig. 1: Pie Chart depicting Source of Information about ORS to mothers T.V 12% Anganawadi 52% Doctor 30% From Neighbours 6% Note: Table made from pie graph. Fig. 3: Pie chart Showing Knowledge of Mothers regarding Home Made ORS DAAL KA PANI 4% SUGAR AND SALT SOLUTIONS 44% DON'T KNOW 52% Note: Table made from pie graph. Fig. 4: Bar Diagram showing the reason for non-usage of ORS during diarrheal episodes child is very small 15% child doesn't want drink 8% consult a doctor 77% Note: Table made from bar graph.
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|Title Annotation:||ORIGINAL ARTICLE|
|Author:||Meena, Jeewan Singh; Arutagi, Vishwanath|
|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Date:||Sep 21, 2015|
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