Knowledge and Reported Practices Regarding Hand Washing amongMothers of Under Five Children

INTRODUCTION

Hand washing is the act of cleaning one’s hand with the use of water or any other liquid or with the use of soap for the purpose of removing soil, dirt and microorganisms. Hand washing is the corner stone of public health. Hygienic behaviour and sanitary services were principal drives of the sharp drop in death from infectious disease in the last 19 century. Hand washing with soap is one of the most effective and cheapest way to prevent diarrhoeal diseases. In addition hand washing with soap can limit the transmission of respiratory disease, the largest killer of children below 5 years. Researchers say that our hand probably carry at least 3000 different bacteria. Diarrhoea and respiratory infections are the number one cause for child death in India. In India, 38% people wash hands with soap before eating and only 30% wash hands with soap before preparing food. Around 9.2% of the total death rate in India is due to improper hand washing which is bacterial.¹

Hand washing with soap is estimated to reduce incidents or diarrhoea by 30% and respiratory infections by 21% in children under the age of five² . Washing hands with water alone is significantly less effective than washing hands with soap in terms of removing germs and hand washing with soap seldom practical.³ Among 5 out of top million diseases of under-five children are related to water sanitation. According to public health association, only 53% of people in India wash hands before eating and only 30% wash hands before preparing food.⁴ . So it is necessary to assess the knowledge and reported practice regarding hand washing practices among mothers of under-five children and then educate them about its importance.

A study conducted on knowledge and practice of hand washing among 513 care givers of under-five children in a rural, Nigerian community concluded that a gap between knowledge and practice of handwashing, was not statistically significant. The study indicated that other factors beyond knowledge may be responsible for poor hand-washing behaviour.⁵

A cross-sectional observational study on hand washing among some communities of West Bengal was done by interview method and observation technique. The result showed that in urban slum area 98% washed their hands with soap after defecation , only 36%, 16% and 2% washed their hands with soap before meal, before serving food and before cooking respectively. However, it was observed that 69% used soap and water for hand washing after cleaning child’s faeces. In rural area 71% used soap and water after defecation while 26% used mud or ash. Only 13%, 1% and 5% used soap and water before meal, before serving food, before cooking and after cleaning the child’s faeces. Most of them were not aware of the importance of the hand washing.⁶ This study aimed to explore Knowledge and Reported Practices Regarding Hand Washing among Mothers of UnderFive Children.

Objectives

1.  To assess the knowledge among mothers of under-five children regarding hand-washing. 
2. To assess the reported practice of mothers of under-five children regarding hand-washing.
3. To determine the association between knowledge and reported practice among mothers of underfive children with their selected baseline variables.

METHODOLOGY

Quantitative approach and descriptive design was adopted for the study.The study was conducted in a selected rural area of Bangalore. Sample size of the study comprised of 60 mothers of underfive children selected by purposive sampling technique. Permission was obtained from the concerned Primary health centre authorities and 60 mothers were selected. The data collection instruments included a proforma of baseline variables of mothers, structured knowledge questionnaire with 10 items and a checklist to assess reported practice. Content validity of tool was checked by experts. The reliability of the knowledge questionnaire was established using Split half technique (Carl Pearson’s correlation method;r=0.92 and r’=0.95). The reliability of practice checklist was established using inter-rater method (r=0.98). The pilot study was conducted and study was found to be feasible and practicable. A formal permission was obtained from the Village leader. Informed consent was obtained from the mothers prior to the data collection.

RESULTS

I. Baseline variables of mothers of under five children.

Of the total 60 mothers, 50% of mothers belonged to 20-29 years, 38.3% had high school education and 48.3% had a monthly income of Rs.9,755-14,632 . About 57.7%having previous knowledge regarding hand hygiene through mass media.

II. Level of knowledge and reported practice of mothers of underfive children regarding hand washing Finding showed that 20% of the mothers of under five children had adequate knowledge, 53% had moderately adequate knowledge and 27% has inadequate knowledge (Figure 1). With regard to practice of hand washing 16% of the mothers of under five children reported good practice, 24 % had average practice and 60 % had poor practice hand washing (Figure 2).

III. Association of knowledge and practice scores with baseline variables of mothers of under five children

There was no significant association of level of knowledge and level of reported practice of hand washing among mothers of under five children with their baseline variables.

LIMITATIONS

The study could include only the mothers of under five children and the investigators could assess only the reported practice no direct observation was made.

IMPLICATIONS

Nurses play an important role in preparing the community and equip the mothers of under five children regarding hand washing in order to prevent the infection and its transmission. The nurse administrator should plan and organise, conduct training programs in different community based on the importance of hand washing, knowledge and practice. Nurses can take an active part in conducting awareness program in various places and increase the public awareness about hand washing.

DISCUSSION

The present study showed that 20% of mothers had adequate knowledge, 53% had moderately adequate knowledge and 27% had inadequate knowledge. A similar study conducted in South India revealed that out of 1898 mothers interviewed regarding their knowledge on hand washing, 77.82% of mother washed their hands with only water. and stated that hand washing is important, 41% thought that hand washing is important only after defecation⁶ . This suggested mothers’ lack of knowledge regarding handwashing, hence further attention is required to enhance knowledge and practice of handwashing⁷. 

In the present study about 16% of mothers reported good practice, 24 % average and 60% had poor practice. A study conducted on hand washing practices in urban and rural communities in and around Kolkata, West Bengal showed that 64% of mothers practicedhand washing with soap and water. Though this was a positive finding, major gaps in the knowledge and practice were identified ⁷.

The present study showed that there was no association between knowledge as well as reported practice of the mothers of under five children and their demographic variables such as age, education, income, previous knowledge and source of information.

CONCLUSION

Hand hygiene is important for all ages of life especially for mothers of under five children to prevent transmission of infection for their children, and prevent gastrointestinal infections. Adequate knowledge regarding hand washing will enable the mothers to put in practice, the hand washing steps in their ordinary day to day life. Housewives should be enlightened with proper knowledge regarding handhygiene and practice it every day to prevent childhood infections.