PRESBYTERIAN UNIVERSITY COLLEGE,

GHANA
DEPARTMENT OF PHYSICIAN ASSISTANT
ASSESSING MOTHERS KNOWLEDGE ON
PREVENTION OF DIARRHEAL DISEASES
AMONG CHILDREN UNDER FIVE YEARS IN
ASANTI-AKYEM AGOGO
BY:
FRANK HENRY NYIMBO
AS/0505/12

Chapter 1

Brief Background of the Study

According to a 2009 report issued by World Health

Organization (WHO) and United Nations Childrens Fund
(UNICEF), diarrhea remains the second leading cause of death
among children under five globally. Nearly one in five child
deaths about 1.5 million each year is due to diarrhea. It kills
more young children than AIDS, malaria and measles
combined.

In 2012, World Gastroenterology Organization issued a report

that, each child under 5 years of age experiences an average
of three annual episodes of acute diarrhea and both the
incidence and the risk of mortality from diarrheal diseases are
greatest among children in this age group, particularly during
infancy thereafter, rates decline incrementally.

Brief Background of the Study

Improvements in access to safe water and adequate sanitation,

along with the promotion of good hygiene practices (particularly
hand washing with soap), can help prevent childhood diarrhea
(WHO & UNICEF, 2009). In fact, an estimated 88 per cent of
diarrheal deaths worldwide are attributable to unsafe water,
inadequate sanitation and poor hygiene (Black, Morris and Bryce,
2003).

In relation to health hazards, a report by WHO (2005) noted that

approximately 4 billion cases of diarrhea each year cause 2.2
million deaths, mostly among children under the age of five. This
is equivalent to one child dying every 15 seconds, or 20 jumbo jets
crashing every day. These deaths represent approximately 15% of
all child deaths under the age of five in developing countries.

Brief Background of the Study

Africa and South Asia are home to more than 80 per cent
of child deaths due to diarrhea. Just 15 countries account
for almost three quarters of all deaths from diarrhea
among children under five years of age annually (WHO &
UNICEF, 2009).

The Ashanti Akyem North District (AAND) in the Ashanti

Region, reported morbidity ranged from 3.40% to 4.0%
among under fives with Agogo Presbyterian Hospital
recorded rates of 3.2% (2006) and 4.2% (2007), (Ashanti
Regional Health Directorate, 2007).

Problem Statement

In recent times, there have been observations of

children under fives years rushed to the Presbyterian
Hospital in Agogo with diarrhea on the cases of
bacterial and viral causes or on nutritional deficiencies,
Lima and Guerrant, (1992).

Mothers are unable to provide appropriate early

treatment leading to deterioration of the condition and
delay in treatment. This is as a result of inadequate or
lack of knowledge,Mugo, (2011).

Problem Statement

From the above facts and fingers, mothers in Agogo

with under-five children will be assessed to know
their level of knowledge on the prevention of
diarrheal diseases.

Purpose of the Study

The purpose of the study was to establish the

knowledge of mothers with under five years children
concerning the prevention of diarrhea disease in the
children.

The study was also aimed to bring out measures that

can be put in place to reduce diarrhea in the under
fives.

Research Objectives
The objectives of the study were to:

To examine mothers feeding practices of children under five

(5) years.

To determine sources of drinking water for their children and

how mothers store it at home.

To determine hygienic practices among mothers of children

less than five years.

To determine how mothers initially manage diarrheal diseases

among children under five years at home.

Chapter 3

Research Design

A non-experimental quantitative descriptive research

design was used to conduct the study.

The quantitative descriptive design is a formal,

objective and systematic process to describe a
phenomenon and elaborate opinions (Burns & Grove,
2005). It can also be used to obtain data to describe
and elaborate perceptions. Therefore this design is
appropriate.

Research Setting

The research was conducted in Asante-Akyem Agogo

Township. Agogo is the district capital of Asante-Akyem
North Municipal of the Ashanti Region of Ghana.

With a population of thirty six thousand, seven hundred and

ninety seven 36,797 in 2013, (Ghana Statistical Service).

A Presbyterian hospital is located here and delivers various

specialised services.

Agogo can boast of a number of schools. These include six

(6) Junior High Schools, two (2) Senior Secondary Schools
and three (3) Tertiary institutions.

Study Population

Mothers or caretakers of children under fives years old

living in Agogo for the past one year was the targeted
population.

Only those who form part of the sampling size drawn

from the accessible population and gave their
verbal/written consent, forms the study population.

Sampling Method and Sample Size

The study participants were selected using convenience

sampling.

In this case the researcher simply entered all the eligible and
accessible places within Agogo community, including homes and
Post-natal Clinic where study units can be gotten.

Through this method, those who gave their consent to participate

after explaining to them the purpose of the study became the study
population unto whom the questionnaires were administered.

Convenience sampling was used to select a sample size of one

hundred (100) mothers with under-five children for the study

Data Collection Tools

To ensure quality of data, both self-administered and

interviewer-administered questionnaire were used;

Written questions were crosschecked to make sure that

all questions were answered properly and systematically.

Responses were collated at the end of each day and

finally stored on a computer.

The study was a non-invasive one to cause any physical

harm. Data collected was also held in strict confidence

Data Analysis

The obtained data was entered and coded, grouped,

tabulated and transferred to a computer software,
Statistical Package for Social Sciences (IBM SPSS)
statistics.

The data obtained from the study was analyzed using

the IBM SPSS statistics, version 20 and the results
presented in tables, cross-tabulations and correlations,
figures, percentages and narratives for easy
understanding and clarification.

Ethical Consideration

The study was approved first by the Department of

Physician Assistant of the Presbyterian University
College, Asante Akyem Campus,Ghana.

Consent was sought from the participants involved in the

research before data was collected.

The researcher also got the concerned official permission

from the chief, assemblyman , medical director of Agogo
Presby hospital, and opinion leaders of the community.

Limitations and Delimitations

The first limitation of the study was the sample size and
the restriction of the data to mothers who were available.
This was as a result of the funds and time earmarked for
such an extensive study. The time allocated was too short
considering the geographical area of the town. This in fact
limits the generalizability of results. Secondly, responses
obtained from respondents are subjected to reporting errors
and biases.

The delimitations were limiting myself in the choice of the

topic and specific objectives. More other areas could have
been explored.

Chapter 4

Feeding Practices

Feeding Practices

Sources and storage of drinking water

Sources and storage of drinking water

Personal hygiene practices

Personal hygiene practices

Personal hygiene practices

Personal hygiene practices

Management of diarrhea disease

Management of diarrhea disease

Management of diarrhea disease

Chapter 5

Summary

This research was conducted to assess mothers knowledge on the

prevention of diarrhea among their children under 5 years.

The results showed that the majority of the people do not practice
exclusive breastfeeding.

Though most mothers said they buy bottled water for their babies,
some obtain drinking water from hand-dug well and in some
cases from rivers.

Shockingly, many of these do nothing to this water before giving

it to their children.

Summary

Lack or inadequate toilet facilities in homes coupled with poor

cleanliness on those who have it, can also act as source of
infection.

Hand washing with soap and water before a mother breastfeed her
child was not satisfactorily and such a practice creates the avenue
for the spread of diarrhea diseases.

Also, instead of using ORS and Zinc tablet as initial home

management of diarrhea as recommended by WHO, most mothers
use only ORS.

However, respondents suggested that they should be given more

education on the prevention of diarrheal diseases in under 5
children

Conclusion

Finally, based on findings from the study, feeding practices,

especially exclusive breastfeeding was poor,

Sources and storage of drinking water for the child was good but
treatment of unwholesome water for drinking was unsatisfactory,

Hand washing practices before feeding the child needs to be

improved,

Strategies must be improved to enable mothers adopt healthy

lifestyles and

Most mothers were using only ORS as initial home management

of diarrhea.

Recommendation
More education on the prevention of diarrhea and its
treatment or management in children.
Provision of toilet facilities by individual homes or by
the assembly.
Mothers be thought when and how to treat and store
drinking water for their children.
I also recommend on further studies into mothers
awareness of Zinc tablet in the management of
diarrhea in children.

References

References

Ashanti Region (2007).Annual Health Report. Ghana.

Ghana population & housing census. (2010). Summary report of final results: Ghana
Statistical Service.

Black, R.E., Morris S. and Bryce J., Where and Why are 10 Million Children Dying
Every Year?, The Lancet, vol. 361, no. 9376, 28 June 2003, pp. 2226-2234.

Burns, N. & Grove, S.K. (2005). The practice of nursing research: Conduct, Critique and
Utilization. 5th ed. Philadelphia: Saunders Company.

Lima A, and Guerrant.(1992). Access to Drinking Water and Sanitation in Africa.Policy

Insights

Mugo, J.M., (2011). Access to Drinking Water and Sanitation in Africa.Policy Insights
.http://www.oecd.org/dev/aeo

UNICEF/WHO, (2009).Diarrhea: Why children are still dying and what can be done. Pg. 5

WHO Report (2005).Household Water Treatment and Storage.

World Gastroentology Organization (2012). Global Guidelines: Acute diarrhea in adults

and children: a global perspective.

Thank You