Knowledge, Attitudes and Practices of Mothers in Relation to Childhood Pneumonia and Factors Associated with Pneumonia and seeking Health Care in Kapsabet District Hospital in Nandi County, Kenya

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.