Parents\u27 perceptions and practices regarding childhood diarrhea management in rural Thatta, Sindh

Diarrhea is the second leading killer after pneumonia among\u27under-five years old worldwide. Childhood morbidity and mortality due to diarrhea is at high threshold in Low and Middle Income Countries (LMICs). In Pakistan, major proportions of these deaths due to dehydration following diarrhea. It is known that with proper use of rehydration salt the morbidity and mortality as a result of severe dehydration could be prevented at household level. Caregivers\u27 misperceptions regarding the causes of diarrhea and the function of Oral Rehydration Salt are major obstacle in its use of ORS despite of a wide availability of ORS. Objective: This study aimed to determine the perceptions and practices of caregivers about childhood diarrhea management at household level residing at rural Thatta, Sindh. Methodology: A Qualitative Exploratory Descriptive research study was conducted in district Thatta Sindh during July-September, 2016. In-depth interviews and FGlls using open-ended semi-structured questionnaire guides were conducted with the parents of under 5. IDIs were also conducted with the 4 HCPs. Study Participants were selected using purposive technique. Findings were compiled using thematic analysis of data. Findings: Study shows majority of the caregivers including fathers having misperceptions about the causes of childhood diarrhea. Such as eating food items from shops, eating immediately after breast feeding, drinking immediately after taking oily food, toddlers falling flat on back (Salt), bad air and mosquitos could cause childhood diarrhea. Based on their perceived causes of diarrhea caregivers\u27 use traditional treatment at home and only take the child to a healthcare facility when all such practices failed. Parents\u27 also have no knowledge regarding the proper usage of ORS. Consequently, this has led to low usage of ORS and subsequent dehydration. There is very little contribution of healthcare providers in imparting awareness regarding childhood diarrhea management at home level and about the usage of ORS. Lack of empowerment of primary caretakers (mothers) in the family is also responsible for the preference of traditional treatments at home level. Finally, illiteracy and lack of education has exacerbated the prevailing situation. Conclusion: Majority of caregivers in rural areas do not have knowledge regarding management of diarrhea and use of ORS. Moreover, based on their perceptions regarding the causes of diarrhea they select traditional home treatments. Healthcare providers\u27 attitude and disinterest in educating the parents also contributes to poor childhood diarrhea management at home. A robust awareness program and education with the help of LH Ws and local NGOs is needed to enhance the usage of ORS. An efficient M&E program should be in place to keep track efficiency of such programs