Application of Health Belief Model in Understanding Wash Behaviour Practices among Mothers of U-5 Children in Lagos Urban Slums

Abstract

The poor practice of Water, Sanitation, and Hygiene (WASH) supports the spread of disease burdens causing high U-5 children mortality rates in developing countries like Nigeria. Knowledge, perception, attitude and other influencing factors become important in determining WASH practices. This study, guided by the Health Belief Model, assessed the knowledge, perception, and attitude of mothers of U-5 children in Lagos urban slums to WASH behaviour messages in order to understand their WASH practices. The cross-sectional study involved 361 mothers of U-5 children in selected Lagos urban slums. Applying cluster sampling and purposive sampling techniques, the study used a pre-tested structured questionnaire through interviews to collect data on knowledge, perception, attitude, and practice of WASH. IBM SPSS Version (26) was used to analyse the data collected, and the presentation was in percentages, tables and charts. The main objective was analysed using path analysis of the structural equation model (SEM) and logistic regression model. Only 15.2% used improved water sources, 44.3% stored drinking water safely, and 10.3% did not treat home drinking water. Open defecation was high (61.8%); Only 22.4% washed their hands with water and soap at critical times; 36.6% disposed of waste into the river and canal; open dumpsites (33.8%), and 29.6% used waste to fill marshy areas in the environment. The majority (90%) favourably perceived the susceptibility of children to the dangers of unsafe drinking water. The mothers positively perceived the benefits of good WASH practice for children’s health, but (31.1%) had low knowledge of the severity of the risk resulting from poor WASH. The mothers’ positive perceptions did not necessarily reflect in their WASH practices. Age, level of education, marital status, and occupation significantly influenced the respondents’ WASH practice. Economic reasons and limited WASH facilities were barriers, while contributions of community leaders were supportive. Study recommendations include; the provision of WASH facilities and more WASH behaviour education for mothers through participatory communication approaches. The WASH behaviour sensitisation model should be reviewed to have a distinct identity from routine immunization programmes; to enable mothers to understand WASH messages better.