Abstract:Background: Malaria disease, a preventable and treatable disease has continued to plague under-five children in rural Nigeria. Unhealthy health practices contribute to increased morbidity from malaria especially in a resource-poor setting. Aim: This study was aimed at determining the prevalence of malaria among the under-five Nigerian children in a resource-poor setting of a rural hospital in Eastern Nigeria and evaluating the health practices of their mothers as regards home antimalaria and herbal medication practices, awareness and use of insecticide treated nets (ITNs) and the practice of abdominal wall scarification. Materials and Methods: This was a descriptive hospital-based study carried out on 196 out of 244 mothers of under-five children who were treated for malaria and met the selection criteria. The mothers were interviewed using a pretested, structured researcher administered questionnaire which elicited information on home antimalaria and herbal medication practices, awareness and use of insecticide treated nets (ITNs) and the practice of abdominal wall scarification. The period of assessment was in the previous six months for ITNs usage. An under-five child was defined to have malaria if the mother gave complaints of fever, vomiting and other symptoms suggestive of malaria, had body temperature exceeding 37.5 o C with the asexual forms of Plasmodium falciparum detected on the peripheral blood film. The data collected included age, sex and diagnosis made. Results: One hundred and ninety six (80.3%) out of a total of 244 under-five children were treated for malaria. Of the 196 under-five children; 128 (65.3%) had home antimalaria treatment, 53(27.0%) received herbal remedies while 15 (7.7%) had antibiotics. The awareness of ITNs was 87.2% while user rate was 11.7%. Eighty three (42.4%) had upper abdominal wall scarification marks. Conclusion: This study has shown that malaria still constitutes a significant health problem in the study area and home treatment of malaria with antimalaria drugs or local herbal remedies and abdominal wall scarification were practised. The awareness of ITNs was high but user rate was low. There is urgent need for effective methods to enlighten primary child care givers (mothers) on appropriate under-five child health practices that are safe, timely, effective and under-five child health friendly and centred.