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Impact of Infant Choking First-Aid Training on Choking Response Skills among Mothers of Infants in Nigeria

Abstract

Infant choking is an important child health and emergency-care concern because infants may place objects or food in their mouths and have immature chewing and swallowing abilities, increasing the risk of airway obstruction. A choking episode can rapidly become life-threatening and requires prompt and appropriate first-aid response while professional medical assistance is being sought. Mothers and other primary caregivers are often the first people present when an infant experiences choking, yet some mothers in Nigeria may have limited knowledge and practical skills regarding choking prevention, recognition of airway obstruction, and appropriate first-aid procedures. Misconceptions about choking management, inappropriate attempts to remove an obstruction, delays in seeking emergency assistance, and limited access to first-aid training may increase the risk of serious outcomes. Infant choking first-aid training provides an opportunity to equip mothers with the knowledge, confidence, and practical skills needed to respond appropriately to infant choking emergencies. Against this background, this study investigates the impact of infant choking first-aid training on choking response skills among mothers of infants in Nigeria. The study will be anchored on Social Cognitive Theory, the Health Belief Model, and the Theory of Planned Behavior. Social Cognitive Theory emphasizes observational learning, behavioural modelling, practical skill development, self-efficacy, reinforcement, and environmental influences in shaping mothers' emergency-response behaviours. The Health Belief Model explains how mothers' perceptions of the seriousness of infant choking, perceived benefits of appropriate first aid, perceived barriers, self-efficacy, and cues to action may influence emergency-response decisions. The Theory of Planned Behavior emphasizes attitudes toward infant first aid, subjective norms, perceived behavioural control, and behavioural intentions as determinants of mothers' preparedness and response to choking emergencies. Collectively, these theoretical perspectives provide a suitable framework for explaining how infant choking first-aid training may influence choking response skills among mothers of infants in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise mothers aged 18 years and above who have infants aged below 12 months and reside in selected urban and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, healthcare facilities, households, and eligible mothers. Infant choking first-aid training will be assessed using indicators such as exposure to structured training sessions, frequency and duration of training, identification of choking hazards, infant choking prevention, recognition of severe airway obstruction, appropriate emergency response, age-appropriate first-aid techniques, safe positioning, appropriate back blows and chest thrusts where indicated, recognition of unconsciousness, activation of emergency medical assistance, appropriate post-event care, and avoidance of harmful interventions. Choking response skills will be assessed using indicators such as recognition of choking, assessment of the infant's condition, correct positioning, appropriate performance of recommended infant choking first-aid manoeuvres, timely activation of emergency assistance, appropriate response when the infant becomes unresponsive, avoidance of inappropriate actions, and appropriate follow-up after the emergency. Data will be collected using structured questionnaires, standardized infant-choking knowledge assessment tools, practical skills checklists, simulated choking scenarios, direct observation, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize mothers' demographic and socioeconomic characteristics, previous first-aid experience, exposure to infant-safety information, knowledge of choking hazards, and baseline choking response skills. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of infant choking first-aid training on choking response skills. Where a quasi-experimental design is adopted, choking response skill scores before and after the training intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that infant choking first-aid training has a significant positive impact on choking response skills among mothers of infants in Nigeria. Mothers exposed to structured, practical, demonstration-based, and competency-focused training are expected to demonstrate better choking-response skills than mothers without comparable training. Training may improve mothers' ability to identify choking, distinguish severe airway obstruction from less serious situations, position an infant appropriately, perform recommended first-aid techniques correctly, activate emergency assistance, and respond appropriately if the infant becomes unresponsive. Hands-on practice using infant mannequins or realistic simulations may improve confidence, reduce hesitation, and strengthen correct performance during emergencies. Training may also improve mothers' knowledge of common choking hazards and encourage preventive practices such as appropriate food preparation, safe feeding, age-appropriate toys, and supervision. However, limited access to first-aid training, financial constraints, geographical barriers, inadequate emergency medical services, cultural beliefs, misinformation, and limited availability of trained instructors may reduce the effectiveness of training alone. The study therefore expects regular, practical, accessible, and competency-based infant choking first-aid training, supported by maternal and child health services and functional emergency-response systems, to contribute significantly to improved choking response skills among mothers of infants in Nigeria. The study is expected to contribute to the literature on infant choking, first-aid training, maternal health education, emergency response, child safety, injury prevention, maternal and child health, caregiver preparedness, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, maternal and child health programmes, nurses, midwives, community health workers, emergency-care providers, child-safety organizations, parent-support organizations, development partners, and policymakers regarding strategies for improving caregiver preparedness for infant emergencies. The study will also provide evidence-based recommendations for integrating infant choking first-aid education into antenatal and postnatal services, strengthening practical caregiver training, improving access to community-based first-aid programmes, promoting infant choking prevention, strengthening emergency referral systems, and developing sustainable interventions that enhance mothers' ability to respond effectively to infant choking emergencies across Nigeria.

Keywords: Infant choking first-aid training, choking response skills, mothers of infants, infant safety, first aid, emergency response, child injury prevention, maternal health education, maternal and child health, caregiver preparedness, Nigeria, public health.