Factors associated with caretakers’ knowledge, attitude, and practices in the management of pneumonia for children aged five years and below in rural Uganda

BACKGROUND: Efforts aimed at reducing morbidity and mortality associated with pneumonia in children aged five years and below largely depend on caretakers. This study aimed to assess the factors associated with knowledge, attitudes, and practices of caretakers regarding pneumonia. METHODS: This was a cross-sectional study carried out within Iganga and Mayuge health and demographic surveillance site (IMHDSS) cohort in Eastern Uganda. Caretakers of children under the age of five years were assessed for knowledge, attitudes, and practices using a set of indicators. The caretaker characteristics as determinants for knowledge, attitude, and practices in relation to pneumonia management were assessed for association. Logistic regression was used to assess the factors associated with caretaker knowledge, attitudes and practices. RESULTS: A total of 649 caretakers of children five years and below of age were interviewed. Caretakers knew pneumonia as one of the childhood diseases, but were less knowledgeable about its transmission, signs and symptoms, risk factors and treatment. Overall, 28% had good knowledge, 36% had moderate knowledge and 35% had poor knowledge. The caretaker attitude was good for more than a half of the respondents (57%), while majority reported good practices (74.1%). Older age (OR = 1.63, 95% CI (1.05–2.51)), Tertiary education (OR = 4.92, 95% CI (2.5–9.65)), being married (OR = 1.82, 95% CI (1.05–3.15)) were associated with having good knowledge. Age above 35 years (aOR = 1.48, 95% CI (1.03–2.11)), and main source of livelihood were associated with good attitude and lastly being female (OR = 2.3, 95% CI (1.23–4.37)), being a Muslim (aOR = 0.5, 95% CI (0.35–0.75)), and being a farmer (OR = 0.5, 95% CI (0.33–0.85)) were associated with being a good caretaker practice. CONCLUSIONS: The caretakers of children five years and below, have relatively adequate knowledge about the signs and symptoms of pneumonia, risk factors and treatment measures. Higher education, being married, and being a salary earner were associated with better knowledge about pneumonia, while being female, being a Muslim, and being a peasant farmer were associated with good practice. Targeted interventions to equip caretakers with relevant and adequate skills and knowledge for lower-income and less educated caretakers, considering cultural and religious beliefs about childhood pneumonia identification and management are required.