KNOWLEDGE, ATTITUDE AND HOME MANAGEMENT PRACTICES OF ACUTE WATERY DIARRHOEA AMONG MOTHERS OF UNDER-FIVE CHILDREN IN BENIN CITY

BACKGROUND: Acute watery diarrhoea (AWD) remains a major cause of morbidity and mortality among children under five years, particularly in low- and middle-income countries such as Nigeria. Despite the proven effectiveness of Oral Rehydration Therapy (ORT) and zinc supplementation, inadequate maternal knowledge, negative attitudes, and poor home management practices persist as key barriers to prevention and control. This study assessed the knowledge, attitude, and home management practices (KAP) of mothers regarding acute watery diarrhoea and identified factors influencing care-seeking behaviour in Benin City, Edo State. METHODS: A communitybased descriptive crosssectional study was conducted among 631 mothers of underfive children in Benin City, Edo State. A multistage sampling technique selected participants from Egor and Ovia NorthEast LGAs to represent urban and periurban settings. Data were collected using a pretested, intervieweradministered structured questionnaire. The instrument was adapted from WHO/UNICEF diarrhoeal disease management guidelines and peerreviewed KAP studies. Data entry and analysis were performed with IBM SPSS version 26. Descriptive statistics summarized sociodemographic characteristics and key study variables. Chisquare and Fisher’s exact tests assessed associations between categorical variables. Logistic regression identified predictors of knowledge, attitude, and practice levels. Statistical significance was set at p < 0.05. Ethical approval was obtained from UBTH Health Research Ethics Committee. Verbal and written informed consent was secured; participation was voluntary and confidentiality maintained. RESULTS: The mean age of respondents was 31.6 ± 5.2 years. Most respondents had attained tertiary education (52.0%), and nearly half belonged to households earning ₦90,000–₦250,000 (47.1%) monthly. Overall, 471 (74.7%) of respondents demonstrated adequate knowledge of acute watery diarrhoea (AWD) and its management. Most mothers correctly defined diarrhoea as the passage of watery stools three or more times daily (81.5%) and identified contaminated food or water as the commonest cause (84.6%). About fourfifths (79.7%) were aware of oral rehydration solution (ORS), yet only 59.4% knew the correct ingredients. Knowledge was significantly associated with education level (χ² = 57.437, p < 0.001), marital status (χ² = 19.285, p < 0.001), and skill level (χ² = 11.047, p = 0.026). Knowledge increased with higher education, marital stability, and occupational skill level—that is, mothers with tertiary education, those who were married, and those in higher skill categories were more likely to have adequate knowledge of acute watery diarrhoea and its management. Logistic regression showed that respondents with at least secondary education were more than twelve times more likely to have adequate knowledge (OR = 12.48; 95% CI: 4.32–35.99; p < 0.001). A total of 497 (78.8%) respondents had a positive attitude toward the home management of acute watery diarrhoea. Majority, 552 (87.6%) recognized diarrhoea as a serious illness and 571 (90.5%) affirmed the need for early medical care; however, 355 (56.2%) still associated diarrhoea with teething. Positive attitude was significantly associated with education level (χ² = 106.088, p < 0.001) and knowledge level (χ² = 80.184, p < 0.001). Respondents with higher levels of education and adequate knowledge were significantly more likely to exhibit a positive attitude toward the home management of acute watery diarrhoea. Multivariate analysis showed that mothers with adequate knowledge were over four times more likely to exhibit a positive attitude (OR = 4.52; 95% CI: 2.78–7.34; p < 0.001). In contrast, only 206 (32.6%) demonstrated good home management practices. While 246 (75.0%) respondents used ORS during diarrhoeal episodes, only 120 (36.6%) continued breastfeeding and 137 (41.8%) administered zinc supplements. Preventive measures such as 474 (75.1%) practicing handwashing before feeding and 335 (53.1%) maintaining exclusive breastfeeding were common, though only 188 (29.8%) reported rotavirus vaccination. Good practice was significantly associated with education level (χ² = 22.687, p < 0.001), skill level (χ² = 11.358, p = 0.023), and number of underfive children (χ² = 17.108, p < 0.001). Mothers with higher education, those engaged in higherskilled occupations, and those with fewer underfive children were more likely to demonstrate good home management practices. Additionally, mothers with adequate knowledge were less likely to exhibit poor practices (OR = 0.29; 95% CI: 0.17–0.48; p < 0.001). Regarding barriers, 447 (70.8%) sought care at a health facility during diarrhoeal episodes, whereas others cited belief in spontaneous recovery (62; 9.8%), long distance to facilities (35; 5.5%), and financial constraints (24; 3.8%). Only 311 (49.3%) had received prior health education—mainly from 210 (33.3%) health workers. Among those reporting challenges at health facilities, 31 (67.4%) mentioned long waiting times, 6 (13.0%) cited overcrowding, and 3 (6.5%) reported poor staff attitude. CONCLUSION: Most mothers in Benin City had good knowledge and positive attitudes toward managing acute watery diarrhoea, but actual home practices were poor. Education and knowledge strongly influenced proper management, while financial and access barriers hindered careseeking. Strengthening health education, ensuring steady ORS and zinc supply, and addressing socioeconomic challenges are essential to improve home management and reduce diarrhoearelated child deaths.