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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 51-55

Knowledge, attitude, and practices on sanitation, water, and hygiene among mothers of under five children in rural area: A cross-sectional study


Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India

Date of Submission31-Dec-2020
Date of Decision10-Mar-2021
Date of Acceptance22-Mar-2021
Date of Web Publication11-Jun-2021

Correspondence Address:
Dr. Sushma Katkuri
Department of Community Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjhs.mjhs_34_20

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  Abstract 


Background: Simple practices such as appropriate washing of the hands, supply as well as use of clean water, excreta disposal in a scientific manner, sanitary latrine use, persona hygiene, etc., help to maintain health and promote the quality of life by preventing a number of diseases.
Objective: The objective of this study is to study knowledge, attitude, and practices on sanitation, water and hygiene among mothers of under five children in rural area.
Materials and Methods: A community-based cross-sectional study was carried out among 347 mothers of under five children in villages around the Rural Health Training Center. Data were collected in semistructured questionnaire where the information was obtained by face-to-face interview.
Results: Majority mothers belonged to 21–30 years (87.3%); educated up to intermediate level (69.7%); were home makers (77.5%) and majority (94.5%) belonged to lower class of socioeconomic status. 43.8% used boiling method to purify water at household level. For the baby food, 31.1% were using boiled water. Majority (84.7%) had adequate knowledge on hand-washing. 71.5% told that hand washing is necessary to keep oneself away from the diseases. 97.1% were washing their hands after defecation and 85.9% expressed the need of soap for hand washing. 33.7% told that flies over food are the cause of worm infections. For diarrhea, 44.4% told that unhygienic food is the cause of diarrhea. 87.1% used dumping for disposal of waste water from kitchen and general household; 82.7% were dumping solid waste. Using the sanitary latrine was seen in 83.3%.
Conclusion: It was observed that the knowledge on purification of water was poor. Second, very few people use boiled water for preparing baby's food. The knowledge about washing of hands after defecation was good.

Keywords: Attitude, hygiene, knowledge, practices, sanitation, water


How to cite this article:
Katkuri S. Knowledge, attitude, and practices on sanitation, water, and hygiene among mothers of under five children in rural area: A cross-sectional study. MRIMS J Health Sci 2021;9:51-5

How to cite this URL:
Katkuri S. Knowledge, attitude, and practices on sanitation, water, and hygiene among mothers of under five children in rural area: A cross-sectional study. MRIMS J Health Sci [serial online] 2021 [cited 2021 Oct 21];9:51-5. Available from: http://www.mrimsjournal.com/text.asp?2021/9/2/51/318154




  Introduction Top


”Sanitation is a way of life. It is the quality of living that is expressed in clean home, clean firm, clean business, and clean community. Sanitation covers the whole field of controlling the environment with a view to prevent disease and promote health.”[1]

Hygiene is general cleanliness; it is also the surrounding conditions which help in the promotion of the health. It involves not only the appropriate clean housing conditions but also appropriate and improved nutrition. Hygiene can be at community level, household level, and individual level. Community hygiene consists of supply of safe drinking water, closed drainage system, collection, and disposal of solid waste in a scientific manner. Hygiene at household levels consists of proper disposal of solid waste, use of sanitary latrine, cleanliness of the house and proper ventilation, spacing, lighting inside the house as well as keeping the animals away from the house. Hygiene at individual level consists of daily bath, trimming the nails, use of clean clothes, regular and appropriate hand washing practices, etc. All these hygienic measures help to promote the individual and community health.[2]

It has been found out that about 1000 children die every day as a result of diarrheal diseases which is an important cause of preventable deaths.[3]

Poor sanitation is said to claim one life every 20 s globally. Water which is not safe and sanitation which is not adequate is said to constitute around 80% of the morbidities in the third world nations.[4]

The Sustainable Development Goals (SDG) are designed in such a way that they are committed toward programs and activities for sanitation and safe water supply in collaboration with all the countries of the world for capacity building. They are designed to support the local communities so that they become self-dependent to manage their sanitation and water management. SDG goal six concentrates and seeks co-operation of the countries for another 15 years with the idea to give access to all the population for sanitation which is adequate and drinking water which is safe.[5]

Communicable diseases like diarrhea can be easily prevented just by sanitation which is adequate and drinking water which is safe as well as following good hygienic practices. Morbidity incidence can be reduced to a great extent by access to sanitation which is adequate as well as use of sanitary latrines helps in the enhancement of the quality of life.[6]

Simple practices such as appropriate washing of the hands, supply as well as use of clean water, excreta disposal in a scientific manner, sanitary latrine use, persona hygiene, etc., help to maintain health and promote the quality of life by preventing a number of diseases.[7]

Measures intended for the secondary prevention of diarrhea include early diagnosis and early use of oral rehydration solution, if the child is breastfeeding, then the breastfeeding should be continued, zinc supplements and appropriate treatment.[8]

Hence, the present study was conducted with the objectives to assess the knowledge, attitude and practices on sanitation, water and hygiene among mothers of under five children and to impart health education on sanitation and water hygiene.


  Materials and Methods Top


Study design

Community-based, cross-sectional study.

Study area

Villages around the Rural Health Training Center, Gummadidala.

Study population

All the mothers of under-five children in villages around the Rural Health Training Center, Gummadidala were study participants.

Sample size

A total of 347 mothers of under-five children were interviewed.

Study duration

Two months.

Ethical considerations

Institution Ethics Committee permission was obtained before the study. Written informed consent was taken from all eligible participants before they were asked the study questions. Health education was imparted to all the study participants to increase the awareness at the end of the study.

Inclusion criteria

  1. All mothers of under-five children who were present at home during the time of survey
  2. All mothers who were willing to participate in the study.


Exclusion criteria

  1. Mothers of under-five children who were unwilling to participate in the study.


Methodology

Data were collected in predesigned, pretested and semi structured questionnaire which was designed for the present study based on the extensive review of the literature. This was questionnaire-based study where the information was obtained by face-to-face interview. Information was collected on source and type of water supply and its treatment, causes of worm infestation and diarrhea in children, knowledge on handwashing and preparing ORS, importance of toilets, place for defecation for children, importance of hand washing practices, and liquid and solid waste management.

Statistical analysis

The data were entered in the Microsoft excel worksheet. Proportions were used to describe the variables in the present study.


  Results Top


[Table 1] shows the distribution of study participants according to socio-demographic characteristics. Majority of the mothers belonged to the age group of 21–30 years (87.3%) followed by 16–20 years (9.2%). Majority of the mother were educated up to intermediate level of education (69.7%), whereas 21.9% were found to be illiterate. Majority of the mother were home makers (77.5%), whereas remaining 22.5% were occupied at some or the other place. 90.8% of the mothers were Hindu. 94.5% of the mothers belonged to lower class of socioeconomic status as per the BG Prasad classification of socioeconomic status which is based on the per capita family income per month.[9]
Table 1: Distribution of study participants according to sociodemographic characteristics

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[Table 2] shows knowledge, attitude, and practices of study participants related to hygiene of drinking water. Majority of the houses (51.9%) were not having the continuous water supply which was seen in 48.1% of the houses. 43.8% of the mothers used boiling method to purify water at household level, but at the same time, 38.3% mother were not bothered about any kind of treatment of the drinking water. 17.9% used some kind of filters for the drinking water. For the baby food, 31.1% of the mothers were found to take precaution of boiling of the water but remaining which formed the majority did not bother about it as they may not be aware about it.
Table 2: Knowledge, attitude and practices of study participants related to hygiene of drinking water

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[Table 3] shows knowledge, attitude, and practices of study participants related to hand hygiene. Majority (84.7%) had adequate knowledge on how to wash hands. 71.5% of the mothers told that hand washing is necessary to keep oneself away from the diseases. 97.1% of the mothers were washing their hands after defecation and 85.9% expressed the need of soap for hand washing.
Table 3: Knowledge, attitude and practices of study participants related to hand hygiene

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[Table 4] shows the distribution of study participants according to the knowledge on causes of worm infestation and diarrhea. 33.7% of the mothers told that flies over food are the cause of worm infections followed by stale food as the cause of the worm infestations by 32.6% of the mothers. For diarrhea, 44.4% of the mothers told that unhygienic food is the cause of diarrhea followed by drinking unsafe water as the cause of the diarrhea by 24.8% of the mothers.
Table 4: Distribution of study participants according to the knowledge on causes of worm infestation and diarrhea

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[Table 5] shows the distribution of study participants based on liquid waste and solid waste management. Majority, i.e., 87.1% of the mothers used dumping for disposal of waste water from kitchen and general household while only 5.8% were properly using it for kitchen gardening. Again majority (82.7%) of the mothers were dumping the solid waste while only 6.6% were found to use it for composting. However, in case of children, the majority of the mothers were found to using the sanitary latrine in 83.3% of the cases, but still 16.7% of the mothers were taking their children in open places for defecation of their children. Among these mothers, only 1.8% of them were disposing it by ground burial.
Table 5: Distribution of study participants based on liquid waste and solid waste management

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  Discussion Top


Clean water and optimum sanitation facilities can prevent the occurrence of various infectious diseases and help in curbing the associated morbidity and mortality. The current study was conducted among mothers of under-five children residing in villages around Malla Reddy Institute of Medical Sciences, Department of Community Medicine, RHTC, Gummadidala.

The study revealed that most subjects were in the age group of 21–25 years (51.87%). From the similar studies conducted in Nepal, most of the subjects were in the age group of 25–35 (56.30%),[10] in Kolkata mothers were mostly between the age of 20–29 (79.33%)[11] and in Bangalore the subjects were mostly between 20 and 30 (44.10%).[12] The current study also revealed that most participants belonged to the religion Hindu (90.78%). This is in contrast to study conducted in Bangladesh (78.10%) and Biye community (100%) where most subjects belonged to Islam religion.[13] Maximum participants in the present study received education up to high school (33.43%) in contrast to the study conducted in Nepal[10] where most of the subjects were illiterates (88.40%). 77.52% of the subjects in the present study were homemakers similar to the study conducted in Kolkata[11] (86.67%), whereas in Nepal[10] most of them were unskilled workers (56.3%).

Maximum subjects belonged to social Class IV (65.99%) in the present study similar to studies conducted in Kolkata[11] (35.33%) and Bangalore (56.9%).[12]

Most of the subjects in the present study received water supply from tap (32.86%). Majority (51.87%) of the subjects in the present study revealed that they had intermittent water supply, same as the study conducted in Kolkata[11] (70.13%) where they also received intermittent water supply. Out of the total participants, only 34.58% consumed purified water. 38.32% of the subjects consumed water without any treatment at household level. Among the remaining participants, most of them used boiling (43.81%) as method of purification, similar to the study in Kolkata[11] (47.17%) but in contrast to Nepal[10] where they used filtration as method of purification (73%).

33.73% of the participants believed that flies over the food causes worm infestation in children, whereas 32.57% thought eating stale food causes the worm infestation. Most of the mothers of under-five children in the present study believed that eating unhygienic food was the cause of diarrhea (44.38%). High majority of the participants (92.50%) had no knowledge of preparing ORS.

The present study revealed that 59.66% of the participants thought that the importance of toilet was to be disease free, similar to that of the study conducted in Bangalore (94.20%).[12] 71.46% of the participants also think washing hands keeps them disease free. 97.12% practiced hand washing after defecation out of which 85.88% used soap, similar to the study in Nepal[10] where 62.6% and 74.67% in Kolkata practiced hand washing after defecation using soap.[11]

Most of the participants (83.28%) used sanitary latrines for defecation and 16.72% used open places for defecation. A study in Nepal[10] showed 51.9%, 83.33% in Kolkata,[11] and 48.2% in Bangladesh[13] used sanitary latrines for defecation. 82.7% of the participants threw solid waste haphazardly in contrast to Nepal,[10] Kolkata,[11] and Bangalore[12] where solid waste was picked up by local municipalities. Only 5.76% of the participants knew liquid waste management, whereas the majority 87.74% threw haphazardly similar that of study conducted in Nepal (51.2%).[10]


  Conclusion Top


It was observed that the knowledge on purification of water was poor. Hence, intense health education should be provided in the community and they should be told about the importance of purification of water. Second, very few people use boiled water for preparing baby's food, so health education should be provided to them. The knowledge about washing of hands after defecation was good. Intense health education campaigns should be conducted at regular interval regarding sanitation and water hygiene so that there will be decrease in morbidity and mortality among under-five children related to diarrheal diseases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Park K. Park's Textbook of Preventive and Social Medicine. 22nd ed. Jabalpur, India: M/s Banarasidas Bhanot; 2013.  Back to cited text no. 1
    
2.
Greene VW. Personal hygiene and life expectancy improvements since 1850: Historic and epidemiologic associations. Am J Infect Control 2001;29:203-6.  Back to cited text no. 2
    
3.
United Nations Development Program. Sustainable Development Goals. Available from: https://www.undp.org/content/undp/en/home/sustainable-development-goals.html. [Last accessed on 2017 Feb 27].  Back to cited text no. 3
    
4.
Karn RR, Bhandari B, Jha N. A study on personal hygiene and sanitary practices in a rural village of Mornag district of Nepal. J Nobel Med Coll 2012;1:39-44.  Back to cited text no. 4
    
5.
United Nations Development Program. Sustainable Development Goals. Available from: https://www.undp.org/content/undp/en/home/sustainable-development-goals/goal-6-clean-water-and-sanitation.html.[Last accessed on 2017 Feb 27].  Back to cited text no. 5
    
6.
Sibiya JE, Gumbo JR. Knowledge, attitude and practices (KAP) survey on water, sanitation and hygiene in selected schools in Vhembe District, Limpopo, South Africa. Int J Environ Res Public Health 2013;10:2282-95.  Back to cited text no. 6
    
7.
Shah D, Choudhury P, Gupta P, Mathew JL, Gera T, Gogia S, et al. Promoting appropriate management of diarrhea: A systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India. Indian Pediatr 2012;49:627-49.  Back to cited text no. 7
    
8.
Munos MK, Walker CL, Black RE. The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality. Int J Epidemiol 2010;39 Suppl 1:i75-87.  Back to cited text no. 8
    
9.
Kulkarni AP, Baride JP, Prasad's Method of Social Classification. Text Book of Community Medicine. 2nd ed. Mumbai;: Vora Medical Publishers, 2002. p. 29.  Back to cited text no. 9
    
10.
Sah RB, Bhattarai S, Baral DD, Pokharel PK. Knowledge and practice towards hygiene and sanitation amongst residents of Dhankuta municipality. Health Renaiss 2014;12:44-8.  Back to cited text no. 10
    
11.
De M, Taraphdar P. A study on water sanitation hygiene and hand washing practices among mothers of under 5 children attending tertiary care hospital in Kolkata, India. J Dent Med Sci 2016;15:54 9.  Back to cited text no. 11
    
12.
Mohd R, Malik I. Sanitation and Hygiene Knowledge, Attitude and Practices in Urban Setting of Bangalore: A Cross-Sectional Study. J Community Med Health Educ 2017;7:540. doi:10.4172/2161-0711.1000540.  Back to cited text no. 12
    
13.
Ercumen A, Mertens A, Arnold BF, Benjamin-Chung J, Hubbard AE, Ahmed MA, et al. Effects of single and combined water, sanitation and handwashing interventions on fecal contamination in the domestic environment: A cluster-randomized controlled trial in rural Bangladesh. Environ Sci Technol 2018;52:12078-88.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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