Knowledge of ORS packet or pre-packaged liquids and its determinants for the management of diarrhea among women of reproductive age: multilevel analysis of 32 sub-Saharan African countries demographic and health survey
Authors: Aragaw Fantu Mamo , Ketema Daniel Bekele , Wolde Maereg 
Published: November 2022

Abstract
Background
Infant and child mortality due to diarrhea is a very serious and widespread problem all over the world, particularly in sub-Saharan African countries. Using an oral rehydration solution (ORS) is an easy, inexpensive, and reliable way of treating dehydration and reducing diarrhea-related mortalities. However, there is limited evidence on the magnitude of knowledge of ORS packets or pre-packaged liquids and determinant factors among women in sub-Saharan African countries. Hence, This study sought to assess knowledge of ORS packets or pre-packaged liquids and determinant factors for the management of diarrhea among women of reproductive age in 32 sub-Saharan African countries.

Method
Data for the study were drawn from a recent 32 demographic and health surveys (DHS) conducted in sub-Saharan African countries. A total sample of 234,848 mothers who gave birth in the last 5 years preceding the survey was included. STATA version 16 was used to clean and analyze the data. Multilevel multivariable logistic regression was employed to identify factors associated with knowledge of ORS packets or pre-packaged liquids in sub-Saharan African countries. In the multivariable analysis, an adjusted odd ratio with a 95% confidence level was reported to indicate statistical association with a P value < 0.05.

Results
The overall magnitude of knowledge of ORS packets or pre-packaged liquids in sub-Saharan African countries were 80.59% (95% CI: 80.42%, 80.74%). Individual-level factors such as women who were aged 25 -39, (AOR = 1.30; 95%CI; 1.27, 1.34) and aged > 35 (AOR = 1.44; 95%CI; 1.40,1.49),women having primary education (AOR = 1.51; 95%CI; 1.47, 1.56), secondary and above education (AOR = 1.80; 95%CI; 1.74, 1.86), women who were working (AOR = 1.38; 95%CI; 1.35, 1.42), household size of 6–10, & > 10, (AOR = 1.08; 95%CI; 1.05, 1.10) and (AOR = 1.10; 95%CI; 1.06, 1.14), women from middle and rich household (AOR = 1.09 95%CI; 1.06, 1.12) and (AOR = 1.51 95%CI; 1.47, 1.56), media exposure (AOR = 1.20 95%CI; 1.17, 1.23), ANC visit (AOR = 2.11 95%CI; 2.04, 2.17), living in regions of East Africa, West Africa and Southern Africa have 2.45 (AOR = 2.45 95%CI; 2.36, 2.53), 2.21 (AOR = 2.21 95%CI; 2.14, 2.27), 1.95 (AOR = 1.95 95%CI; 1.83, 2.08) were significantly associated with womens knowledge about ORS packet or pre-packaged liquids.

Conclusion
One in five women does not know ORS packets or pre-packaged liquids. Maternal age, women’s education, working status, household wealth index, household size Media exposure, ANC visit, and region were significant predictors of knowledge of ORS packets or pre-packaged liquids. Therefore, it is better to give special emphasis to young age, women who had no formal education and who have no media exposure, poor households, those women who have not currently working as well as those who have a household size of greater than six. Furthermore, it is critical to increase ANC visits to improve knowledge of ORS packets or pre-packaged liquids.