Determinants of oral rehydration salt utilization among under-five children with diarrhea in Ethiopia: A multilevel mixed-effect analysis

Abstract

Background: Oral rehydration salt therapy is a critical intervention to reduce mortality and morbidity of children with diarrheal diseases. However, it remains underused in low- and middle-income countries. In Ethiopia, only less than half of children with diarrheal diseases were treated with oral rehydration salt solution. Therefore, the objective of this study was to identify the determinants of oral rehydration salt utilization among children with diarrhea in Ethiopia. Method: A secondary data analysis was done using the 2016 Ethiopian Demographic and Health Survey. A weighted sample of 1227 children who had diarrhea in the last 2 weeks with their index mothers during the 5 years survey was included in the study. A multilevel mixed logistic regression model was fitted to identify factors associated with oral rehydration salt utilization. Finally, statistical significance was declared at p-value < 0.05. Result: The overall prevalence of oral rehydration salt utilization for children with diarrhea was 29.5%. In this study, age of mother ⩾35 (adjusted odds ratio = 1.66, 95% confidence interval = 1.05, 2.64), mothers with formal education (adjusted odds ratio = 1.52, 95% confidence interval = 1.09, 2.11), media exposure (adjusted odds ratio = 1.72, 95% confidence interval = 1.25, 2.38), living in Metropolitan regions (Addis Ababa and Dire Dawa (adjusted odds ratio = 1.76, 95% confidence interval = 1.14, 2.69)), and small peripheral regions (Afar, Gambela, Somalia, Benishangul-Gumuz (adjusted odds ratio = 1.69, 95% confidence interval = 1.22, 2.34)) were associated with higher odd of oral rehydration salt utilization for children with diarrhea. Conclusion: The study concludes that the age of mothers, educational status of the mother, media exposure, and regions of mothers were determinants of oral rehydration salt utilization for children with diarrhea. Therefore, media advertising regarding diarrhea management should be scaled up to increase oral rehydration salt utilization for children with diarrhea. Special attention to socio-cultural constraints or beliefs regarding diarrhea management should be given to mothers from large to center (Tigray, Amhara, Oromia, Southern Nations Nationalities, and People’s Region, and Harari) regions.

Prevalence of oral rehydration solution use and its determinants in the treatment of diarrhea among under-five children in sub-Saharan Africa

“…This may be attributed to the assumption that educated women are more equipped with information about childcare and child welfare than uneducated women. For instance, it was emphasized in previous studies that educated mothers understand better the complications of childhood diarrhea and as a result would seek early and appropriate treatment for their children [14][15][16][17][18].…”

“…This may be attributed to the fact that women in households with 2 or more children share their time with more children which may lead them into paying little attention to the plight of such children [23]. Relationship between water source and ORS use shows that children from households with improved water source are more likely to receive ORS compared to children from households with non-improved water source [14]. This may be explained by the assumption that that since water is involved in the preparation of ORS, women from households with improved water source are more inclined to prepare the solution.…”

The Relationship of Supplementary Feeding, Breast Milk (MP-ASI) to Infants with The Event of Diarrhea

“…The target of The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) is to reduce the death rate from diarrhea to 1 per 1000 live births (Hosangadi et al, 2019;Masanja et al, 2019) in 2025 (Girma et al, 2022). The diarrhea morbidity rate in Indonesia in IJNI ► 2 IJNI, Vol.…”