Diarrhoea management in primary health care facilities in the Cape metropole region: the caregivers' perspective

Abstract

This mini-thesis, assessed the use of ORT as a treatment for childhood diarrhoea in primary health care facilities in the Cape Metropole from the caregivers' perspective. Awareness and knowledge of oral rehydration therapy (ORT) and the preparation abilities of sugar salt solution (SSS) by caregivers of children younger than 5 years attending the health facilities were assessed. The availability of resources and utensils for the use of ORS packets and SSS and the accessibility to health facilities by caregivers were also determined. Using a cross sectional descriptive study design, a baseline situation review was carried out. Primary health care facilities in three heath districts namely; Khayelitsha, Nyanga and Oostenberg were purposely selected. Ninety-two caregivers in 12 facilities participated in the study. Basic analyses of quantitative data were done using Epi-Info 2002 software. Qualitative data were analysed manually. The study found that according to caregivers, all facilities used ORS packets as their immediate treatment for uncomplicated diarrhoea, and recommended sugar salt Diarrhoea Management in PHC Facilities solution as home treatment. Ninety-one percent of caregivers used ORT at home before they presented to the health facility.Of the caregivers who were advised by the health worker to use SSS at home, 60.7%, 55.8% and 60.2% in Oostenberg, Khayelitsha and Nyanga districts respectively remembered the correct ingredients and quantities to make the solution at home. Of those given ORS packets, 94.5%, 99.0% and 98.5% respectively, remembered the quantity of water to be mixed with each packet. Packets were found to be convenient and were preferred by many caregivers as compared to SSS. The advice or health education messages given to caregivers were often unclear, and there were language barriers in Brighton and Bloekombos clinics in the Oostenberg district. A litre bottle was available in 47% of caregivers' homes, 82 % had a teaspoon and all of them had access to running water. Twelve percent and 11 % admitted to not having sugar and salt respectively when they wanted to make SSS. Eighty-eight percent walked to the health facility and 12% used taxis or buses. The study concludes that ORT is widely used in primary health care facilities for diarrhoeal disease treatment, however caregiver's knowledge and preparation abilities of SSS is still limited. The resources and utensils to prepare ORT at home were fairly available in many homes, which makes SSS preparation at home feasible and acceptable.