Child to parent education in prevention of acute respiratory infec-tions in rural school under rural health training centre

Child to parent education in prevention of acute respiratory infec-tions in rural school under rural health training centre V. Mutalik A.1*, V. Raje V.2 DOI: https://doi.org/10.17511/ijphr.2017.i5.01 1* Anirudh V. Mutalik, Assistant Professor, Department of Community Medicine, KMCT Medical College, Calicut, Kerala, India. 2 Vaishali V. Raje, Professor, Department of Community Medicine, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India.


Introduction
Acute Respiratory illness in developing countries is one of the major cause of mortality and morbidity among under five children with more than 7 million deaths every year worldwide [1]. Most prevalent illnesses of childhood include acute respiratory tract infections, malnutrition and diarrheal diseases in the middle and low income countries [2].
Acute respiratory diseases are reported to be the 3rd leading cause of child morbidity and mortality [3]. Acute Respiratory diseases continues to affect the developing world causing in more than 3 million deaths, accounting for 15.5% of total childhood deaths i.e. under 5 years [4]. Among all developing countries India ranks 2nd for three quarters of death due to Acute respiratory illness in under five population [5,6].
One of the most important determinants of child survival is the knowledge and attitude of the Child's mother towards diseases. Mother forms the core of all families across the societies and is known to be primary caretaker of child. Hence, knowledge, attitude and health practices of mothers impacts directly on the health of the child.
Appropriate and holistic health education on the causation, symptoms, signs, its prevention can help in early identification of the ante respiratory diseases and hence health seeking behavior. This can certainly change the picture of mortality and morbidity among under five due to acute respiratory illness. Health education forms the fundamental element of primary health care.
According to the reports the incidence of acute respiratory diseases in rural India is 11.3% and in urban India is 8.5% [7]. Looking towards these figures, one can understand the prime need of improvement in health status by providing health education to the right person through the right mode.
So by educating school children we can educate their mother, father his siblings and the community.
Thus school children can act as a health educator to community and be a part to prevent and control common diseases in their area. This study is an attempt to find out the effect of child to mother education particularly with regards to acute respiratory diseases in rural area.

Objective
Aim of the study was to find out the change in level of knowledge, attitude and practice of parents after receiving health education from their school going children.
To find out the existing knowledge, attitude and practice towards acute respiratory diseases among school going children and parents. To find out improvement in knowledge, attitude, practice in school children after giving health education to them. To find out the improvement in parent's knowledge, attitude and practice after providing health education to children regarding acute respiratory diseases. Scoring system was developed to assess both pre and posttest performance of study and control group.

Material and Methods
Correct answer was given score 1 and wrong answer and uncertain answer 0. Grading of knowledge, attitude and practice was done as 0-1= Poor, Data related to knowledge, attitude, practice on acute respiratory infections among 9th students and mothers will be collected in predesigned and pretested questionnaire for both study and control.
The mothers were interviewed personally.
Children of study group was educated regarding causes, symptoms, signs, treatment and prevention of ARI with the help of study instruments (charts, posters, demonstrations etc.). Demonstration on detection danger signals of ARTI was given in school to study subjects and assignment was given to them to perform same at home with the help of mother. The health education session was carried out 4 times in a month for 1 hour for study groups of each standard.

Results
The maximum number of children belonged to age group 15 yrs and 14 yrs.
It was observed that almost 3/4th of strength of study & control group was due to boys. The difference between two groups was not found statistically significant. This was found to be similar with gender too. (p>0.05).
According to Table I Difference in two groups was found not significant.
It was observed that nearly two third of students (72.3%) belonged to middle class followed by lower (25.7%) and upper class. No significant difference for Socioeconomic status observed among both study and control group. Students from both the groups were asked 12 questions to assess their knowledge, attitude and practice regarding acute respiratory disease.
Same questions were asked after imparting education and demonstration related to acute respiratory diseases. Table II           According to  (Table IX).
After intervention mean score of overall KAP and individual knowledge, attitude and practice was increased among children of study group (intervention) and their mothers compared to nonintervention group (control) children and their mothers.
From Table V and VI it was clear that poor and average KAP regarding Acute Respiratory Infections among children had significantly increased (Good) after giving Health Education and demonstration to study group children compared to control group to whom these sessions were not conducted.
Even KAP of mothers of children for whom sessions were conducted had increased significantly, from poor to good, in comparison with mothers of children for whom sessions were not conducted.

Discussion
Mother forms the core of all families across the societies and is known to be primary caretaker of child. Hence, knowledge, attitude and health practices of mothers impacts directly on the health of the child.
A appropriate and holistic health education on the causation, symptoms, signs, its prevention can help in early identification of the ante respiratory diseases and hence health seeking behaviour.
According to age group and gender, mean age was 15 years (range: [13][14][15]  which involved family members observed that less proportion of correct answers before the intervention. However, at final follow-up they found increase in proportions of correct answers which were highly significant among intervention group as compared to non-intervention group.
Similar study done by C.E.O Reilly et al [13] showed improvement in Knowledge regarding correct water treatment after intervention, Elizabeth Blanton et al [19] reported that parental awareness of flocculent disinfection of water increased post intervention& Christopher Vaughan et al [15] showed increase in number of correct answers between the pre test and post test among mothers.
All the studies reported above and the current study are suggestive of children are the best media to transfer information to the family members.

Conclusion
One of the most important determinant of child survival is the knowledge and attitude of the Child's mother towards diseases. Mother forms the core of all families across the societies and is known to be primary caretaker of child. Hence, knowledge, attitude and health practices of mothers impacts directly on the health of the child.
A appropriate and holistic health education on the causation, symptoms, signs, its prevention can help in early identification of the ante respiratory diseases and hence health seeking behaviour. Hence children especially the school going children can be used as an effective tool to transmit health education among the families and communities.
The current study adds that the children can effectively learn and be vehicle of change among the communities regarding health education.