Factors influencing the home-based management of diarrhoea in children under five years in the rural Matzikama sub district in the Western Cape

Date
2017-03
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : The high incidence of diarrhoea in children under five years of age is a great concern and becomes a priority to decrease the level of child morbidity and mortality worldwide. The aim of this study was to investigate the factors influencing the home-based management of diarrhoea in children under five in the rural Matzikama sub district in the Western Cape. The objectives for the study were to determine whether the following factors influenced the home-based treatment of diarrhoea: demographical factors; socio-economic factors; the knowledge of mothers and caregivers about the home-based management of diarrhoea; and the participant’s previous involvement with the management of diarrhoea. A quantitative approach with a descriptive design was applied in the study. A total population of N=195 of mothers and caretakers of children under five were included in the study obtained through convenient sampling. The data collection instrument was a self-administered questionnaire. A structured interview was conducted with the participants with limited literacy skills. Reliability and validity were ensured by a pilot study done in Klawer Clinic in the Matzikama Sub-District and furthermore assisted by primary health care experts, the study supervisor and co-supervisor, and a statistician from the University of Stellenbosch. Ethics approval was granted by the Health Research Committee of Stellenbosch (S14/05/120). Permission was obtained from the Health Department of the Western Cape Government to conduct the research in the Vredendal-North and Vredendal-Central clinics in the Matzikama Sub-District in the West Coast District. (WC_2014RP59_660). Informed written consent was obtained from the participants. With the support of a qualified statistician at the Stellenbosch University data was analysed using the STATA 14 computer software program. Descriptive statistical analysis was applied, cross tabulation between the biographical data and the successful treatment of diarrhoea at home was done applying the Fisher’s exact probability test. The results of the data were presented in tables and bar graphs. A response rate of 100% was obtained. The categorical data of nominal variables did not fall into any rankable order, therefore no arithmetical calculations like addition, subtraction, multiplication or division could be performed. The identified factors that indicated a statistical significant difference between the successful home-based treatment of diarrhoea in this study were: the number of people in the house (p=0.003); the information source on the management of diarrhoea (p=0.005); and the successful treatment versus the unsuccessful treatment of diarrhoea at home (p=0.000). Based on the demographical variables, the knowledge level on diarrhoea is poor. Results further show that only 21% of participants knew the correct answers on the knowledge-based questions, while 79% answered incorrectly. The study showed no statistical significant difference between the knowledge-based questions and the age, gender and highest school grade passed. Recommendations for this study include: training about the management of diarrhoea at home-based level for community care workers, mothers and caregivers, and health care workers; social mobilization on awareness of diarrhoea; and family and health care support to mothers and caregivers in the management of diarrhoea at home-based level. The implementation of these recommendations may lead to the reduction of child morbidity and mortality.
AFRIKAANSE OPSOMMING : Die hoe voorkoms van diarree in kinders onder die ouderdom van vyf jaar is kommerwekkend en raak 'n prioriteit om kindermorbiditeit en -mortaliteit wereldwyd te verminder. Die doel van hierdie studie was om die faktore wat die tuis-gebaseerde behandeling van diarree in kinders onder die ouderdom van vyf jaar in die landelike omgewing van die Matzikama subdistrik in die Wes-Kaap beinvloed, te ondersoek. Die doelwitte vir die studie was om te bepaal of die volgende faktore die tuis-gebaseerde behandeling van diarree beinvloed: demografiese faktore; sosio-ekonomiese faktore; die kennis van moeders en versorgers oor die tuis-gebaseerde behandeling van diarree; en die deelnemer se vorige betrokkenheid by die tuis-gebaseerde hantering van diarree. 'n Kwantitatiewe benadering met ‘n beskrywende ontwerp is toegepas in die studie. 'n Totale bevolking van N = 195 van moeders en versorgers van kinders jonger as vyf jaar was deur ‘n gerieflike steekproefmetode in die studie ingesluit. Die data versamelingsinstrument was 'n selftoegediende vraelys. ‘n Gestruktureerde onderhoud was gevoer waar deelnemers ‘n mate van ongeletterdheid getoon het. Betroubaarheid en geldigheid is verseker deur 'n steekproefstudie te doen in die kliniek in Klawer, in die Matzikama subdistrik en verder geassisteer deur kenners op die gebied van primere gesondheidsorg, die studieleier en mede-studieleier, asook 'n statistikus aan die Universiteit van Stellenbosch. Etiese goedkeuring is verleen deur die Gesondheidsnavorsingsetiekkomitee aan Stellenbosch (S14/05/120). Toestemming is verkry vanaf die Departement van Gesondheid van die Wes-Kaapse regering om die navorsing in die Vredendal-Noord en Vredendal-Sentraal klinieke in die Matzikama Sub distrik in die Weskusdistrik te doen. (WC_2014RP59_660). Ingeligte skriftelike toestemming is verkry van die deelnemers. Met die ondersteuning van 'n gekwalifiseerde statistikus by Stellenbosch Universiteit is data ontleed met behulp van die STATA 14 rekenaarsagteware program. Beskrywende statistiese ontleding is toegepas, kruistabulasie tussen die biografiese data en die suksesvolle tuis-gebaseerde behandeling van diarree is gedoen, en die Fisher se presiese waarskynlikheidstoets is toegepas. Die resultate van die data is in tabelle en staafgrafieke aangebied. 'n Reaksie-tempo van 100% is verkry. Die kategoriese data van nominale veranderlikes val nie in enige opvolgende orde nie, dus kon daar geen aritmetiese berekeninge soos byvoeging, aftrek, vermenigvuldiging of verdeling uitgevoer word nie.Die geidentifiseerde faktore wat 'n statistiese beduidende verskil tussen die suksesvolle tuis-gebaseerde behandeling van diarree in hierdie studie aangedui het, is: die aantal mense in die huis (p = 0.003); die bron van inligting oor die bestuur van diarree (p = 0.005); en die suksesvolle behandeling teenoor die onsuksesvolle behandeling van diarree by die huis (p = 0.000). Gebaseer op die demografiese veranderlikes, is die kennisvlak van diarree swak. Resultate het verder getoon dat slegs 21% van deelnemers het geweet wat die korrekte antwoorde op die kennis-gebaseerde vrae is, terwyl 79% dit verkeerd beantwoord het. Die studie het getoon dat daar geen statistiese beduidende verskil tussen die kennisgebaseerde vrae en die ouderdom, geslag en hoogste skoolgraad geslaag, is nie. Aanbevelings vir hierdie studie sluit in: opleiding oor die tuis-gebaseerde hantering van diarree vir gemeenskapsorg-werkers, moeders en versorgers; maatskaplike mobilisering oor die bewustheid van tuisgebaseerde hantering van diarree; en familie en gesondheidsorg ondersteuning aan moeders en versorgers met die tuisgebaseerde hantering van diarree. Die implementering van hierdie aanbevelings mag lei tot die vermindering van kindermorbiditeit en -mortaliteit.
Description
Thesis (MCur)--Stellenbosch University, 2017.
Keywords
Diarrhoea -- Preschool children, Diarrhoea -- Home care, Households -- Economic aspects -- Western Cape (South Africa), Households -- Social aspects -- Western Cape (South Africa), UCTD
Citation