Abstract:
Pneumonia is one of the most common childhood killers in developing countries. In
efforts to meet the Millennium Development Goal of reducing child mortality, there is
need to prioritize pneumonia prevention and appropriate management of cases. The
main objective of this study was to evaluate knowledge, attitudes and practices of
mothers in relation to childhood pneumonia at Kapsabet District Hospital in Nandi
County, Kenya. A hospital-based cross-sectional study was conducted among mothers
attending the Maternal Child Health Clinic from August 2012 through to November
2012. A total of 422 mothers were recruited and structured questionnaires administered.
Using SPSS, descriptive statistics were used to summarize mothers’ demographic data,
recognition and response to childhood pneumonia. Binary Logistic regression was used
to identify factors that predicted mothers’ knowledge of pneumonia and health care
seeking behaviour. Additional data was obtained through focus group discussions and
key informants interviews which were subjected to qualitative analysis. Majority of
mothers (93.1%) knew what pneumonia is. However, (67.1%) perceived childhood
pneumonia as highly dangerous. Mothers who previously had a child suffering from
pneumonia, mothers’ level of education and the total number of children showed
significant associations with knowledge of pneumonia. Mothers who previously had a
child suffering from pneumonia were approximately 6 times more likely to have
knowledge of pneumonia than those who did not (Adjusted Odds Ratio (AOR) 6.3 [95%
CI 1.4-27.9]). Subsequently, mothers with more than three children were more likely to
have knowledge of pneumonia compared to mothers with three or less children (AOR
13.0 [95% CI 2.7-62.9]) and also those with higher levels of education compared to
those with reduced levels of education (AOR 14.3 [95% CI 1.3-161.3]). A majority
(75.8%) picked chest pain from a list of possible signs and symptoms and (82.4%)
indicated they would visit the nearest health facility or a doctor if they thought their
child was suffering from pneumonia. However, a substantial proportion (49.5%) would
not seek treatment/advise immediately or within 24 hours. Mothers’ level of education,
mothers who previously had a child suffering from pneumonia and the perceptions
towards childhood pneumonia showed significant associations with healthcare seeking
behaviour. Mothers with higher levels of education were more likely to seek immediate
medical help compared to those with reduced levels of education (AOR 20.5 [95% CI
2.4-173.5]). Mothers who previously had a child suffering from pneumonia (AOR 34.7
[95% CI 14.1-85.2]) and those who perceived pneumonia as highly dangerous (AOR
10.4 [95% CI 2.2-48.5]) were also more likely to seek immediate healthcare. The
majority (96.7%) believed pneumonia is caused by weather change and (93.4%) would
clothe warmly during cold season to prevent pneumonia. There was no known home
treatment for pneumonia in this community and the majority (77.3%) would feed a sick
child with fluids at home prior to hospital attendance. This study showed most mothers
knew what pneumonia is and would mention at least one feature of pneumonia. Delayed
seeking of healthcare may hinder effective management of pneumonia and inappropriate
home management practices are likely to interfere with treatment. This study highlighted
the need for continued health education on childhood pneumonia at the community
level.