Assessing the Feasibility of Visual Charts to Augment Diarrheal Disease Prevention Practices: A Qualitative Study with Caregivers in Kenya

Abstract

Background: Diarrhoeal disease remains a leading cause of morbidity and mortality among children under five, particularly in low-income urban settings. Despite interventions such as rotavirus vaccination, vitamin A supplementation, improved hand hygiene, and water, sanitation, and hygiene (WASH) initiatives, diarrhoeal episodes persist. Visual charts offer a potentially effective educational tool for low-literacy populations. This study explored the feasibility and acceptability of using visual charts to support diarrhoeal disease prevention practices among caregivers in Nyalenda, Kenya.
Methods: A qualitative descriptive study was conducted using in-depth interviews with 14 caregivers of children aged 6 to 24 months and key informant interviews with 2 community health assistants and 2 health facility in-charges. Participants were purposively sampled based on child age, recent diarrhoeal episodes, and residence stability. Interviews were audio-recorded, transcribed, and thematically analysed.
Results: Caregivers had considerable knowledge of diarrhoeal disease and prevention, but practices were inconsistent due to economic and environmental constraints, including limited soap and safe water access, unimproved sanitation, and congested living conditions. None of the participants had prior exposure to visual charts. All caregivers and health providers expressed strong interest in using visual charts, suggesting content on handwashing, water treatment, food hygiene, and solid and liquid waste management, with materials in English, Kiswahili, and Luo. Charts were envisioned as household reminders and training aids.
Conclusions: Visual charts were well-received and considered feasible to support diarrhoeal disease prevention in resource-limited settings. Findings highlight high receptivity and potential for future interventions to enhance knowledge and adherence to preventive practices.