Barriers to acute management of diarrhea in the home setting: An explorative study of under-five caregivers in southwestern Nigeria

Abstract

Objectives: Diarrhea remains the second leading cause of morbidity and mortality among children under 5 years of age. Persistent mortality and poor outcomes despite available treatments such as oral rehydration salts (ORS) and zinc tablets are indicators of possible barriers to home management among under-five caregivers. This study was designed to explore the potential barriers encountered by under-five caregivers in providing home management for acute diarrhea within the first 24 hours of recognition. Materials and Methods: This qualitative study was conducted among under-five caregivers attending Primary Health Centers in Ikorodu Local Government Area of Lagos State, Nigeria. Twelve under-five caregivers, who indicated in the larger cross-sectional study that they did not provide any form of home management for the child within the first 24 hours of recognizing diarrhea were interviewed. Interviews were recorded. Naturalized transcription, peer in vivo inductive coding, and debriefing w ere done. Th ematic a nalysis was c onducted and findings were presented as themes and subthemes. Results: Three themes emerged: (1) Waiting for natural stoppage of diarrhea, (2) perceived function of ORS/ zinc, and (3) disconnect between potential consequences of diarrhea and action taken. Subthemes include perceived cause and seriousness of diarrhea, misdiagnosis, misinformation on the functions of ORS/ zinc from health-care providers, and lack of awareness of potential consequences of untreated diarrhea. Conclusion: The study showed that the main barriers to providing adequate home management were caregivers’ perception of the cause and seriousness of diarrhea and the misinformation about the function of ORS and zinc therapy. Continuous and accurate education of under-five caregivers would improve the timely initiation of ORS/ zinc and correct home management of acute diarrhea.