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Base de datos de evaluación

Evaluation report

VTN 2000/002: KAP Survey on ARI/CDD Care for Children at Household Level



Executive summary

Background

Since 1998, thanks to the support from UNICEF ARI project, the National ARI has been implementing more innovative IEC activities, such as message dissemination through village's local loudspeakers, video and particularly household level inter-personal IEC for groups of mothers who have children under 5 years old. In order to assess this new project and plan appropriate strategy in the coming years, the national ARI project has conducted a survey on ARI/CDD home care at some communes of the districts where IEC activities have been implemented.

Purpose / Objective

In ARI, the knowledge, attitude and practice of the mothers play an important role in the reduction of morbidity and mortality of pneumonia. The objective of this survey is to:
1. assess the knowledge, attitude and practices of the mothers and fathers of children under 5 years old on ARI/CDD home care
2. assess the result of the implemented IEC activities at the community level to recommend strategies for improving the program in coming years.

Methodology

Data was collected from 1,216 mothers and 1,231 fathers of children under 5 in 8 communes of 4 districts located in 3 regions: Thach Ha (Ha Tink), Vo Nhai (Tahi Nguyen), Cu Jut (Dac Lac) and Cau Ngang (Tra Vinh). In the 8 communes, only 4 have implemented the IEC activities for mothers' groups. This provided a control for studying the impact of these activities.

This is the first time fathers have also been surveyed concerning their knowledge, attitudes and practices on home care for sick children. The interviewer tried to conduct the interviews out of ear shot of the subjects' spouse but it may not have been possible within the constraints of the family's home. This may have influenced responses.

Key Findings and Conclusions

1. The majority of mothers and fathers 86.7% understood that pneumonia is dangerous for children. However, only 59% of parents interviewed knew that fast, difficult breathing is a sign of pneumonia in a child. 46.5% and 75.8% of parents recognized that coughing and fever respectively are signs of pneumonia. A low percentage of the parents knew danger signs for taking a child to a health centre: lethargic 10.4%, giving up breast feeding 10.3%, convulsion 9.3% and chest in-drawing 3.6%. 55.6% of parents used antibiotic as a first home treatment and considered it as the best treatment for coughs and colds; only 17.7% used traditional remedies.

16.6% of parents did not know about diarrhoea. 60% of the interviewees correctly replied on the effect of ORS but only 54% prepare ORS according to the guidelines and 13% offered ORS for children with diarrhoea. The proportion of parents that knew how to prevent pneumonia and diarrhoea was quite good; feeding 60%, washing hands with soap 58%, preventative immunizations 47% and extra feeding 15%.

2. 32% of interviewees replied that they did not get any health information. The main source of health information was from health workers 56%, TV 49%, local loud speakers 37%, radio 27% while little information came from teachers and no information was reported to have been received from newspapers. 71.5% of the interviewees watch TV regularly while only 46% listen to radio programs.

Overall, mothers who participated in the IEC mothers' groups were better informed about ARI and CDD. 86% of mothers knew that fast breathing is a sign of pneumonia compared to 56% in other areas. 28% of mothers do not treat a cough or cold with antibiotics as the first home treatment while 10% of the control group do not. The percentage of mothers who know about the effects of ORS and correctly prepare ORS fluids is higher in communes with IEC groups: 76% vs. 45%. There is no statistical significance between the two groups in recognising the signs of severe disease.

Recommendations

The mothers' groups played an important role in the improvement of mothers' knowledge and practice on child home care. This method is strongly recommended as communication intervention in coming years.

Interpersonal direct communication, especially with health workers, is an important and effective channel to reduce the gap between knowledge and practice for child home care on ARI/CDD. This communication channel should be strengthened at the household and community levels, and includes both fathers and mothers. Information should be reinforced and disseminated regularly through mass media channels such as TV and radio.

The following are the priority topics to be included in communications on home care practice: 
- Recognition of the signs of severe sickness requiring immediate referral to a health facility
- Recognition of the signs of pneumonia
- Changing of treatments for diarrhoea and cough/cold; replacing the misuse of antibiotics as primary self-medication at home by correct use of ORS and other fluids, and traditional cough relief remedies as the treatments of choice
- Explicit instructions/demonstrations on the correct preparation and administration of ORS



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Report information

Date:
2000

Region:
EAPRO

Country:
Vietnam

Type:
Evaluation

Theme:
Health - CDD

Partners:
Ministry of Health National ARI Project (Vietnam)

PIDB:

Follow Up:

Language:
English

Sequence Number:
2000/002

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