Incorporation of child survival strategies among mothers in Zambia : a knowledge, attitude and practice survey
Banda, Dorothy H.S.M.
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The stuck sought to determine mothers' knowledge, attitude and practice of child survival strategies in rural Zambia, in respect to growth monitoring immunisations, breast feeding, nutrition/weaning, oral rehyclration therapy. Family Planning and Malaria prevention A total number of 100 mothers, with children of 18 to 36 months, were selected from Chipata District of Eastern Province from both the rural and semi-urban, by multistage lottery sampling of clinics and residential areas, and quota sampling of respondents. Data as collected from January to April 1998 and a semi-structured interview schedule and locus group discussion guides were used to collect data. The mam findings showed that: Knowledge of the importance of growth monitoring is good in that 92% knew its purpose. On the contrary, attitude and practice are poor since only 55% look their children. Knowledge, attitude and practice of breast feeding especially exclusive breast feeding is poor in that 58% of mothers felt that exclusive breast feeding was bad. 75% of respondents introduced weaning food to their babies at less than 6 months old and most of these gave water other than breast milk, indicating that proper exclusive breast feeding is nearly non existent. Only 5% of those who were still breast feeding their under 24 months children were semi-urban respondents. The knowledge about breast feeding patterns is poor in that the majority, 53% felt that the suitable age to stop to breast feed a child is 18 months. Majority of children, 76% were fully immunized although the coverage is below the recommended 80%. About 62% were not aware of immunization schedules. Knowledge, of good feeding and weaning are poor. Although 94% could identify some foodstuff (e.g. groundnuts) as essential for child growth, only a few gave it to their children. The weaning practice is poor in that 75% of mothers introduced their children to weaning food at less than 6 months and mostly at three months old. Only 67% gave porridge with groundnuts as first weaning food. 73% of these were rural mothers. The poor feeding and weaning practice is evidenced by (the children's growth curves among which a good number (45%) were below the "Road to Health". Knowledge of recommended child spacing is very good (100%). On the contrary, child spacing/family planning practice is very poor, as only ]9% used modem family planning inspite of one's parity, and literacy status. This signifies a very big gap between knowledge and practice. 73% of family planning users, used contraceptive pill. Knowledge of appropriate home diarrhoea management is poor in that 71% of mothers knew the constkuents needed for making home made ORSS (salt, sugar solution). Unfortunately, only 37% managed diarrhoea, at home appropriately, signifying poor practice. Knowledge and practice of malaria prevention are both poor. Very few mothers used bed nets, mosquito repellents and insecticides (10%), 11% and 6% respectively). It was however established that hardly any health talks were given to mothers on malaria prevention and home diarrhoea management at health centres. It was observed that the practice of child survival strategies is good in villages where MCH outreach activities are still implemented and where community health workers are very active. This indicates that to some extent, health care providers' commitment to service and availability of logistics such as transport have an impact on mothers' knowledge, and practice of child survival strategies, because most findings tested statistically have not proved the presence of any significant relationship. Location seemed to have an impact on family planning and weaning practices while literacy status determined preventive measures against malaria. The P.value were 0.03, 0.02 and 0.003 respectively. There is urgent need for policy makers and programme planners to pay particular attention to their intensification of health education programmes and implementation of child survival strategies, especially family planning, malaria prevention, exclusive breast feeding and oral dehydration therapy. Both mothers and fathers should be involved. There is also need to expand (he roles of Community Health Workers regarding dissemination of scientific knowledge (1L;C) of child survival strategies. In addition they should be equipped with the know-how of simple procedures such as growth monitoring and ORS preparation. There is need for a health and social policy that will empower women to make decisions about practices that promote their own health and the health of their children. It is hoped that mothers would therefore incorporate child survival strategies in their child rearing and this will in turn improve child health and promote child survival in rural Zambia.
- Medicine