Comparative analysis of diarrhea management strategies among caregivers of under-five children in rural and urban areas of Rivers State, Nigeria

Diarrhea remains a major contributor to morbidity and mortality among children, particularly in developing countries. This study examined determinants of diarrhea management practices among caregivers in rural and urban areas of Rivers State, Nigeria. A cross-sectional survey was conducted among caregivers using structured questionnaires to assess management practices, socio-demographic factors, and household hygiene behaviours. Chi-square tests and logistic regression were applied to identify significant determinants. Urban caregivers demonstrated better diarrhea management practices than their rural counterparts, with 62.8% exhibiting good practices, compared to 40.5% in rural areas. The use of oral rehydration salts (ORS) and zinc was higher in urban communities (50.4%) than in rural communities (17.8%), whereas traditional remedies such as coconut water and scent leaf were more commonly used in rural settings. Urban caregivers also reported superior hygiene behaviours. Key determinants of good management practices included maternal age, higher household income, and exclusive breastfeeding. Although education and occupation initially showed associations, these associations were not significant in the adjusted models. The urban caregivers were more likely to apply WHO-recommended diarrhea management strategies, while rural caregivers relied more on traditional remedies. Strengthened public health interventions are needed to improve caregiver practices in rural areas.