Knowledge of prescription of zinc and low-osmolarity ORS for under-five children with diarrhoea by Primary Healthcare Workers in Ibadan, Nigeria
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Resum
Background: Zinc supplement plus Low Oral
Rehydration Salt (Zn+Lo-ORS) solution has been
recommended for the management of acute
diarrhoea. Studies have shown that it has the potential
to reduce diarrhoea-related mortality by up to 88%.
Nigeria has adopted the recommended diarrhoeal
management policies and although, it is not known
how many children with diarrhoea access Lo-ORS,
the proportion of children who received zinc
supplementation increased from less than 1% in 2008
to over 2% in 2013. Majority of diarrhoea patients in
Nigeria are treated with antibiotics by Primary
Healthcare Workers (PHCWs) who are the first line
of contact for many of these children. However, little
is known about the level of knowledge of Zn+LoORS
by the PHCWs and their knowledge of prescription
of Zn+Lo-ORS, in Ibadan.
Objectives: The objective was to assess the level
of knowledge of Zn+Lo-ORS and of its prescription,
for under-five children with diarrhoea amongst
PHCWs in Ibadan. Factors associated with the level
of knowledge of Zn+Lo-ORS and of prescription of
Zn+Lo-ORS were also determined.
Subjects and methods: This was a descriptive
cross-sectional study among PHCWs in five local
government areas of Ibadan. Information from 200
PHCWs, selected via a three-stage sampling
technique, was obtained using a self-administered
questionnaire. Descriptive statistics, Chi-square and
logistic regression tests were utilized in analysing
quantitative data with the level of significance set at
P < 0.05.
Results: The PHCWs were from seven cadres, mean
age 40.6 ±9.90 years, 191 (95.5%) females, and 85
(42.5%) had been on the job for 16-20 years. Only
69.5% had good knowledge of Zn+Lo-ORS and
51.3% had knowledge of correct prescription of
Zn+Lo-ORS for the treatment of childhood diarrhoea.
Chi-square tests revealed significant association
between respondents’ cadre and knowledge of
Zn+Lo-ORS (X 2= 19.33, P< 0.001); and knowledge
of prescription of Zn+Lo-ORS (X 2=18.63, P< 0.001).
PHCWs with 1-5 years of working experience were
more likely to have good knowledge (OR= 1.65; 95%
CI = 0.46-5.84) and those with 6-10 years of working
experience were more likely to prescribe (OR= 1.95;
95% CI = 0.78-4.84) Zn+Lo-ORS compared to 16-
20 years. Midwives were more likely to have good
knowledge (OR= 10.20; 95% CI = 1.75-59.36) and
more likely to prescribe (OR= 22.14; 95% CI = 2.35-
208.15) Zn+Lo-ORS compared to other cadres of
PHCW.
Conclusion/Recommendation: The primary health
care workers’ level of knowledge and prescription
of zinc and Lo-ORS for childhood diarrhoea was sub
optimal. Primary health care workers should be trained
periodically on current management guidelines.
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