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Influence of Diarrhoea Prevention Education on Oral Rehydration Therapy Practices among Mothers of Under-Five Children in Nigeria

Abstract

Diarrhoeal disease remains an important public health problem among children under five years of age in Nigeria and continues to contribute to childhood morbidity, dehydration, malnutrition, and preventable deaths. Appropriate home management of diarrhoea, particularly the timely and correct use of oral rehydration therapy, is an important component of reducing complications associated with diarrhoeal illness. Diarrhoea prevention education provides mothers with information about the causes and transmission of diarrhoeal diseases, safe drinking water, sanitation, hand hygiene, food hygiene, breastfeeding, appropriate complementary feeding, prevention of dehydration, and the correct use of oral rehydration solution (ORS). Oral rehydration therapy practices refer to the appropriate preparation, administration, frequency, and continued use of ORS during childhood diarrhoeal episodes, as well as appropriate healthcare seeking when danger signs are present. In Nigeria, inappropriate management of childhood diarrhoea may be associated with inadequate knowledge, incorrect preparation of ORS, misconceptions about diarrhoea treatment, delayed initiation of oral rehydration therapy, reliance on inappropriate home remedies, and limited access to healthcare services. Effective diarrhoea prevention education may improve mothers' knowledge and practical skills and encourage appropriate oral rehydration therapy practices. Against this background, this study investigates the influence of diarrhoea prevention education on oral rehydration therapy practices among mothers of under-five children in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive and health-related behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding mothers' decisions regarding diarrhoea prevention and oral rehydration therapy. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping health practices. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from diarrhoea prevention education may influence oral rehydration therapy practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how diarrhoea prevention education may influence oral rehydration therapy practices among mothers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from mothers or primary caregivers of under-five children in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire and, where appropriate, a practical assessment of ORS preparation. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, households, and eligible mothers. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured diarrhoea prevention education covering causes and transmission of diarrhoeal diseases, safe water, sanitation, hand hygiene, food hygiene, breastfeeding, prevention of dehydration, preparation and administration of ORS, appropriate continued feeding during diarrhoea, recognition of danger signs, and timely healthcare seeking. Oral rehydration therapy practices will be assessed using indicators such as preparation of ORS according to instructions, appropriate volume and frequency of administration, timely initiation of ORS during diarrhoeal episodes, continued feeding and breastfeeding, appropriate storage and use of prepared ORS, and prompt healthcare seeking when danger signs occur. Descriptive statistics will be used to summarize mothers' sociodemographic characteristics, diarrhoea prevention knowledge, exposure to education, and oral rehydration therapy practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the influence of diarrhoea prevention education on oral rehydration therapy practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that diarrhoea prevention education has a significant positive influence on oral rehydration therapy practices among mothers of under-five children in Nigeria. Mothers exposed to structured diarrhoea prevention education are expected to demonstrate improved knowledge of diarrhoeal disease prevention and greater competence in the appropriate use of oral rehydration therapy. Education may encourage mothers to initiate ORS promptly when diarrhoea occurs, prepare ORS correctly, administer appropriate amounts at appropriate intervals, continue breastfeeding and feeding, and recognize danger signs requiring professional healthcare. However, education alone may not guarantee appropriate oral rehydration therapy practices because mothers may continue to face barriers such as inadequate access to ORS, financial constraints, poor access to healthcare facilities, misconceptions about diarrhoea treatment, reliance on traditional remedies, and limited availability of health information. Consequently, diarrhoea prevention education is expected to be most effective when supported by reliable availability of ORS, accessible healthcare services, clean water and sanitation facilities, and continuous community-based health education. The study is expected to contribute to the literature on childhood diarrhoea prevention, oral rehydration therapy, child survival, maternal and child health, health education, and public health in Nigeria by providing empirical evidence on the influence of diarrhoea prevention education on oral rehydration therapy practices among mothers of under-five children. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, local government health authorities, primary healthcare facilities, hospitals, community health workers, maternal and child health programmes, development partners, and policymakers regarding strategies for improving home management of childhood diarrhoea. The study will also provide evidence-based recommendations for strengthening maternal education on diarrhoea prevention, improving practical ORS preparation skills, ensuring consistent availability of ORS, integrating diarrhoea education into routine child-health services, strengthening community-based health promotion, and encouraging timely healthcare seeking for children with severe diarrhoeal illness across Nigeria.

Keywords: Diarrhoea prevention education, oral rehydration therapy practices, mothers, under-five children, oral rehydration solution, childhood diarrhoea, child survival, health education, maternal and child health, diarrhoea prevention, public health, Nigeria.