Diarrheal illnesses remain a major public health concern in the majority of developing countries. Diarrhoea is still one of the leading causes of death in children under the age of five, accounting for around 6,00,000 deaths per year. Every year, an estimated 1.3 million people suffer from diarrhoea around the world. Children living in rural areas of developing countries account for around 4.1 percent of all deaths. The prevalence of diahorrea in India is no different from other developing countries. As per NFHS V the prevalence of diahorrea two weeks preceding survey was 7.3% in India and 3.6% in Chhattisgarh.

The leading cause of diarrhoeal disease were noted to be unhygienic conditions; unsafe water and poor hygienic practices being adopted by care givers before feeding the child. The morbidity due to diahorrea has been associated with lack of awareness among the care givers in terms of identification of signs of dehydration, lack of understanding on its association with hygienic practices and adoption of poor feeding practices by the care givers.

Due to unsafe water and lack of sanitation is the greatest cause of morbidity and mortality in under-five children in the world, especially in poor countries.

Objective Of the Study

• To assess the awareness level among the care givers regarding signs and symptoms of danger signs in diahorrea episodes

• To assess the knowledge of the care givers on importance of ORS supplementation in diahorrea diseases

• To assess the Feeding practices of mothers of under five children with diarrhoea by using structured knowledge on practice questionnaire

Data Source

The study is based on the primary data collected from care givers of children of the age group 6 months- 5 Years residing in 5 urban slums of Raipur. In order to get a complete representation of Raipur, the slums were selected from all corners of the city. The study was based on collecting information from caregivers of children 6 months -5 Years of age through a pre-structured questionnaire.

Total Respondents

The study was conducted in 5 urban slums of Raipur. The activity was continued for 7 days in all 5 slums. A total of 1000 respondent’s data was captured. The clients were both the parents as wel as the care givers of children in the age group of 6m-5 years.

Study Design

The study is primarily a quantitative study in which the data has been collected on the basis of pre designed questionnaire. The questions were based on the current knowledge and attitude of care givers towards care provided to children during diahorrea.

Mothers had some understanding of diarrhoea prevention and the fluids/foods that should and should not be given during bouts of diarrhoea. Dehydration symptoms were poorly understood. None of the mothers could recall all of the steps involved in making the correct and comprehensive oral rehydration salt (ORS). Only 15 percent of mothers stated that the goal of giving ORS solution to their children during diarrhoea is to keep them hydrated. The mothers had little or no knowledge of nutritional requirements during diahorrea (Table 1).

Table 1: Awareness on Use of ORS during Diahorrea

Of the total respondents 45% had awareness regarding use of ORS in diahorrea where as 55% were not aware of the rationale behind giving ORS during diahorrea (Table 2).

Table 2: Awareness of Mothers on Routes of Transmission of Diahorrea

The questions on awareness of mothers regarding routes of transmission of diahorrea showed that awareness among mothers and care givers under this segment was also poor (Table 3).

Table 3: Awareness of Diahorrea Causing Dehydration

Only 40% of mothers/caregivers had knowledge on the spread of diahorrea through improperly washed hands. 70% of the respondents were not aware of flies spreading diahorrea by sitting in eatables .60% were aware of spread of diahorrea through contaminated food and water.

Upon asking the mothers on whether they were aware that dehydration can be caused due to diahorrea there were mixed responses, while 60% of the respondents said they are not aware of it, 30% had said they were aware of diahorrea causing dehydration and 10% said they will choose not to answer the question. 

The respondents were asked regarding the signs and symptoms of dehydration. The questions were asked on the major 7 symptoms which denotes onset of dehydration in children were asked. The findings are presented in (Table 4).

Table 4: Symptoms of Dehydration and Response

Of all the respondents only 33% were aware of dry mouth as a symptom of dehydration. Only 23% were aware of decreased skin turgor which is a sign of major dehydration. The awareness in terms of lack of energy and less amount of urination was appropriate.

The respondents were also asked about the feeding practices that should be adopted during diahorrea. The table below shows the feeding practices being adopted by care givers during diahorrea (Table 5).

Table 5: Awareness on Feeding Practices

There were 450 respondents with children of less than 2 years. They were asked regarding the breastfeeding practices to be adopted during diahorrea. The table below shows the response of breastfeeding mothers (Table 6).

Table 6: Awareness on Breastfeeding Practices

Despite progress in reducing diarrheal disease-related mortality, the disease's burden remains unacceptably high. To reduce the burden of diarrhoea among children in slums, it is critical to raise awareness regarding the various aspects of the diseases which must include targeted SBCC strategies to address the root cause of increased mortality and morbidity of the disease. There is a need to raise awareness on the feeding practices among the care givers and parents so that further morbidity can be reduced. The SBCC strategy for diahorrea management should not be a stand-alone strategy but should be a comprehensive diarrheal disease control strategy which must incorporate improved case identification and management, addressing social determinants of health such as environmental sanitation and clean drinking water, health promotion regarding preventive practises such as breastfeeding and feeding practices during episodes of diahorrea, and research in the field of cost-effective interventions.

Acknowledgment

Authors would like to thank the local leaders, the Mitanins, AWW and the ANM of the area for facilitating the process of data collection during the study and also to the care givers and parents for their active participation in sharing information.

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