Factors associated with safe preparation and home use of sugar-salt solution

The use of oral rehydration salts is frustratingly low, mostly because one must visit a health care provider to procure the packets. Mothers are advised to use sugar-salt solution (SSS) and other home-based fluids as first fluid replacement during diarrhoea. However, the use rate of SSS is also not encouraging and few mothers can prepare it correctly. We conducted an observation study on mothers who reported to the diarrhoea treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh during September 1990 through to December 1992. At quarterly intervals, 240 mothers were recruited randomly to elicit their knowledge and ability to prepare SSS. Most (94.6%) of the mothers knew about the solution, but only 62% of them used the solution at home. The use rate was higher when mothers came to know about the solution through interpersonal communication (e.g. community health workers, doctors, friends, neighbours and relatives) and from multiple sources (72%) than when they learned about it from the media or from a single source (54%). As many as 85.4% of the mothers could prepare the solution within the safe limits of sodium concentrations (30 to 100 mmol/l). The figure rose to 95.8% after practical instruction as to how to prepare the solution. This improvement was dependent neither on the literacy level of mothers nor on their knowledge and use of the solution earlier. To increase interpersonal communication and to improve mothers' behaviour in using and correctly preparing SSS, every contact with health care providers should be utilised for organising sessions on the use and preparation of the solution.