An Exploratory Study on home remedies used by the mothers of under five children in the Management of Upper Respiratory tract Infection in selected rural areas of Haldwani and their relevance in Ayurvedic System of Medicine

Mrs. Priyanka Joshi*

Nursing Tutor, Droan College of Nursing, Vill and Post, Khanpur Purab Dineshpur Road,

Rudrapur- 263153, Uttarakhand, India.

*Corresponding Author E-mail: priyankapandey0566@gmail.com

ABSTRACT:

Introduction: Upper respiratory tract infections in under-five children are one of the main public health problems in India. The researcher felt that the study on home remedies used by the mothers of under five children in the management of Upper respiratory tract infections and their relevance in Ayurvedic system of medicine would provide baseline data to improve the health practices of mother of under five children and quality of life among under five children. Hence the present study, proposes to explore the home remedies being used by the mothers as first hand remedy to protect the children from upper respiratory tract infections. Therefore, it is essential to identify the home remedies being used and whether these remedies have passed on by local tradition. Methodology: To achieve the objectives of the study quantitative research approach was used. The researcher adopted exploratory research design for the present study. The sampling technique adopted for the study was non probability purposive sampling technique with sample size of 75 mothers of under five children. The instruments, used for data collection, were developed in three sections, such as; Section I- Demographic variables, Section II- Semi-structured questionnaire on home remedies and Section III- structured checklist on reason for resorting to home remedies. Major findings of the study: Descriptive statistics were used to analyze the data. Most of the children, 49.3% (37) were suffering from upper respiratory tract infections. Maximum mothers, 90.6 % (68) got information about the use of home remedies from their family members and majority of the mothers, 70.6% (53) were home maker, who were using home remedies for the management of upper respiratory tract infection in their children. Maximum mothers, 36% (27) mentioned that they were using zinger+ honey+ black piper in their child while 28% (21) mothers were using milk with turmeric powder for their child. Maximum mothers, 32% (24) informed that their child was having running nose and watery eyes during upper respiratory tract infection while 22.6% (17) mothers mentioned that their child was having throat pain/irritation. Most of the mothers, 28% (21) noticed their child lethargic. Most of the mothers, 78% (58) noticed improvement in their child as they started administration of home remedy/remedies while 22% (17) mothers did not. Most of the 29% (22) mothers mentioned that the recovery from the symptoms of upper respiratory tract infection took four days and same number of mothers mentioned six days. Most of the mothers, 42% (31) were using home remedy quarter times in a day and 38.6% (29) mothers were using home remedy thrice in a day. Majority of the mothers, 65.4% (49) observed positive effects and 17.3% (13) mothers mentioned that they were using two systems of treatment (Allopathic and home remedies), so they were not sure for the effectiveness of used home remedy. Maximum mothers, 36% (27) mentioned the reason of resorting home remedies that they were advised by the old family members, 18.6% (14) mothers informed that home remedies are easily available at home and 18.6% (14) mothers found positive effect of home remedies during previous experience.

KEYWORDS: Home remedies, Upper respiratory tract infections, Mothers of under five children, Ayurvedic System of Medicine.

INTRODUCTION:

Upper respiratory tract infections (URTI) are one of the most significant health problems in under five children. Upper respiratory tract infections are acute respiratory infections of related structures including sinuses, middle ear, nasal cavity, plural cavity, hard palate, oral cavity, tongue, pharynx and larynx. It includes all infections of less than thirty days duration. It may cause inflammation of respiratory tract anywhere from nose to alveoli with a wide range of combinations of signs and symptoms. Upper respiratory tract infections can be bacterial, viral, fungal, and protozoal infections in any structure of the Upper respiratory tract, like trachea, larynx, pharynx, sinuses etc.Most of the Upper respiratory tract infections easily spread from one person to another person. Some common types of Upper respiratory tract infection includes tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold.¹

In India acute respiratory tract infections is one of the leading causes of morbidity and mortality in young children. In acute respiratory tract infection, (ARTI) children usually have symptoms like loss of appetite, difficulty in breathing, nasal blockage and also sucking difficulty in breastfeed babies.

NEED FOR THE STUDY:

From the ages, Indian rural population has been dependent on the health knowledge and practice derived from oral tradition. It does not make a difference to the rural population how many medical colleges are in India and how many new hospitals have come up. They have been only living on whatever resources are available in the rural areas for meeting the basic care needs. Having known this plight of the rural masses and a lack of health care, it is necessary to explore what type of alternative resources (home remedies) they are using to prevent diseases, to treat the common ailments and to maintain health.

It is equally necessary to analyze the relevance of these home remedies in treating the upper respiratory tract infection. Ayurveda has been the oldest science of medicine present in India from thousands of years. This study aims to identify the home remedies and its relevance to Ayurvedic system of medicine so that the home remedies used, may be preventing for most of the children from complications and aggravation of Upper respiratory tract infection.

If the relevance of the remedies is identified, the researcher may be given appropriate health education regarding how immediately and appropriately they can be used to prevent or to manage the Upper respiratory tract infections.

Ayurvedic medicine is one of the world’s oldest holistic (Whole body) healing systems. It was developed more than 3,000 years ago in India. It’s based on the belief that health and wellness depend on a delicate balance between the mind, body, and spirit. Its main goal is to promote good health, not fight disease. But treatments may be geared towards specific health problems. Ayurveda is a system of medicine with historical roots in the Indian subcontinent. Globalized and modernized practices derived from Ayurveda traditions are a type of complementary or alternative medicine. In countries beyond India, Ayurveda therapies and practices have been integrated in general wellness applications and in some cases in medical use. Charka, an Ayurveda Physician during BC 300 added his own easy- to –easy understand compilation of Agnivesa Samhita. He re-named it as Charka Samhita. Because of his efforts, he is referred to as the Father of Indian Medicine.²

RESEARCH STATEMENT:

“An exploratory study on home remedies used by the mothers of under five children in the management of Upper Respiratory Tract Infection in selected rural areas of Haldwani and their relevance in Ayurvedic System of Medicine”.

OBJECTIVES:

· To assess the prevalence of Upper Respiratory Tract Infections in under five children.

· To identify the awareness of mothers of under five children regarding the uses, composition, dosage and side effects of home remedies used by them.

· To identify the reasons of resorting to home remedies by the mothers of under five children in the management of Upper respiratory tract infection.

· To verify the relevance of commonly used home remedies in Ayurvedic System of Medicine.

· To give information to the mothers regarding the relevance of home remedies.

OPERATIONAL DEFINITIONS:

Home Remedies:

Home remedies refers to any type of herbal raw materials prepared and used by the mothers for the management of upper respiratory tract infections administered orally or external application or both. [Tulsi leaves, hot drinks, garlic, honey, ginger and rose water, steam inhalation, jaggery, harad and any other home remedies but not limited to them]

Mothers of under five children:

It refers to women who are having one or more children in the age group of (0-5) years, who have suffered at least once with upper respiratory tract infection.

Upper Respiratory Tract Infection:

Upper respiratory tract infections are acute respiratory tract infections; it’s including sinus infections, nasopharyngitis, epiglottitis, pharyngitis, laryngitis.1

Relevance in Ayurvedic System of Medicine:

In this study, relevance refers to the approval of the home remedies by the experts of Ayurvedic System of Medicine, as remedies are bring used for the management of Upper respiratory tract infection.

Variables:

Demographic variables:

It consisted of mothers education, father’s education, mother’s occupation, father’s occupation, mother’s income, fathers income, number of under five children in family, types of family, number of episodes of upper respiratory tract infections during last year, number of child suffering from upper respiratory tract infections during the period of data collection, source of information of home remedies and number of times used home remedies in the management of upper respiratory tract infections.

Research variables: Home remedies, upper respiratory tract infections and knowledge of mothers.

Research Metodology:

Research Approach: Quantitative research approach

Research Design: Exploratory research design

Population of the study: In the present study population includes mothers of under five children.

Sample: the present study, sample consisted of mothers of under five children, who are having at least one child suffering with upper respiratory tract infections.

Sample Size: The sample size was 75 mothers who are having under five children suffering with upper respiratory tract infections.

Sampling Techniques: Non probability: purposive sampling techniques.

Data collecting instruments:

Section I: Socio demographic variable

Section II: Semi structured questionnaire on home remedies

Section III: Structured checklist on reasons for resorting to home remedies

RESULT AND DISCUSSION

Section 1: Description of sample characteristics

Table 1: Description of sample characteristics in frequency and percentage n=75

Sample characteristics	Frequency	%
Mother’s education:
Graduate and Above	34	45%
Intermediate	22	29%
High school	11	15%
Primary school	6	8%
No formal education	2	3%
Father’s education:
Graduate and Above	46	61.40%
Intermediate	17	22.60%
High school	7	6.60%
Primary school	5	9.40%
No formal education	0	0
Mother’s occupation:
Government employee	3	4%
Private employee	10	13.40%
Businesswomen	9	12%
Homemaker	53	70.60%
Father’s occupation:
Government employee	26	34.60%
Private employee	25	33.40%
Business man	13	17.40%
Farmer	11	14.60%
Mother’s income (Monthly):
Nil	53	70.60%
Rs. 1000 – 5000/-	1	1.30%
Rs. 5001-15000/-	7	9.40%
Rs. 15001-25000/-	13	17.30%
Rs. 25001-35000/-	1	1.40%
Father’s income (Monthly):
Rs.5000-15000/-	5	6.70%
Rs. 16000-25000/-	12	16%
Rs 25001-35000/-	9	12%
Rs 35001-45000 /-	23	30.70%
Above 45000/-	26	34.60%
Number of under five children in family:
One	50	67%
Two	25	33%
Type of family :
Joint family	34	45.40%
Nuclear family	41	54.60%
Number of episodes of upper respiratory tract infection during the last year:
Twice	18	24%
Thrice	25	33.40%
More than thrice	32	42.60%
No. of children, suffering from upper respiratory tract infection during period of data collection.
	37	49.30%
Sources of information for home remedies: Family members (mothers, mother-in-law, sister-in- law)
Neighbors	68	90.60%
Mass media	3	4%
Health care providers	4	5.40%
Number of times, used home remedies in management of upper respiratory tract infection:
Once	1	1.40%
Twice	21	28%
Whenever needed	53	70.60%

Section 2: Description of mothers’ awareness regarding home remedies.

Table 2: Frequency and percentage distribution of home remedies n=75

(Multiple responses)

S. No.	Home remedies	Methods and Composition of using home remedies	Mode of using home remedies	Botanical name	Total number of respondent (frequency)	%
1.	Steam inhalation	Steam inhalation with 1liter lukewarm water	Inhalation		17	22.6%
2.	Tulsi leaves in warm water	4-6 Tulsi leaves mix in 1/2 cup lukewarm water	Syrup	Ocimum sanctum	9	12%
3.	Zinger+ honey + Black pepper	One spoon honey + 2 pinch black pepper + two drop zinger juice	Oral Mixture	Zingiber officinale + honey bee + pepper	27	36%
4.	Milk and turmeric powder	Half tea spoon turmeric powder in half glass lukewarm milk	Oral mixture	Curcuma longa with milk	21	28%
5.	Harad in milk	One pinch harad powder in one glass lukewarm milk	Syrup	Haritaki with milk	5	6.6%
6.	Ajwain	7-8 ajwain in half glass lukewarm water (approx 25 ml).	Gargling	Trachyspermumammi	5	6.6%
7.	Lemon and zinger	2-3 drops lemon and zinger mix in Half glass lukewarm water.	Syrup	Citrus x limon and Zingiber officinale	1	1.3%
8.	Gargling with salt water	One teaspoon salt mix in one glass lukewarm water and gargling	Gargling	-	10	10%
9.	Jaggery, honey	One teaspoon honey mix with one spoon jiggery	Oral Mixture	Jaggery with honey	6	8%
10.	Honey or honey with milk	One tea spoon honey 5ml with 125ml lukewarm milk	Syrup	Honey bee	14	18.6%
11.	Long oil /ajwain oil	Massage with 5ml long oil and ajwain oil once	Massage	Pepper longum and Apiumgraveolens	5	6.6%
12.	Eucalyptus leaves	2-4 eucalyptus leaves mix in prepared food	Oral mixture	Eucalyptus globules	2	2.6%
13.	Muleti	½ teaspoon muleti mix in 125ml prepared tea and ½ spoon muleti powder mix in 1 spoon honey	Syrup /oral mixture	Glycyrrhiza glabra	5	6.6%
14.	Ashwagandha	½ teaspoon	Oral mixture	Withania somnifera	1	1.3%
15.	Tulsi leaves with honey	4 tulsi leaves mix in 1 spoon honey	Oral mixture	Ocimum sanctum with honey bee	1	1.3%
16.	Arrowroot	2 spoon arrowroot powder mix in prepare tea 120 ml	Syrup	Marantaarundinacea	1	1.3%
17.	Jayfal	½ spoon nutmeg mix in 1 cup warm milk	Syrup	Myristica fragrans	2	2.6%
18.	Warm water	2-3 spoon warm water	Syrup	-	2	2.6%
19.	Curry leaves	4 leaves mix in food	Oral Mixture	Murrayakoenigii	1	1.3%
20.	Black cardamom	½ teaspoon used in food	Oral Mixture	Amomum subulatum	5	6.6%
21.	Eucalyptus leaves	4-5 leaves mix in the food	Oral Mixture	Eucalyptus globobulus	3	4%
22.	Jayfal	Powder ½ spoon mix in food	Oral Mixture	Myristica fragrans	7	9.3%

The above table shows that maximum 61.3% (1) of the mothers were using tulsi leaves with honey, most of the 36% (27) mothers were using zinger+ honey+ black piper for their child in the management of upper respiratory tract infections. About 2.6% (2) of the mothers were using warm water and eucalyptus leaves. Only 1.3% (1) of mothers was using lemon and zinger method and arrowroot for managing the upper respiratory tract infections in their children.

Table 3: Frequency and percentage distribution of symptoms of upper respiratory tract infections n=75

(Multiple responses)

S. No.	Symptoms of upper respiratory tract infections	Number of samples (frequency)	%
1.	Running nose	24	32%
2.	Nasal congestion	9	12%
3.	Dry cough	11	14.6%
4.	Grunting sound	6	8%
5.	Watery eyes	24	32%
6.	Sneezing	13	17.3%
7.	Fever	11	14.6%
8.	Throat pain/irritation	17	22.6%
9.	Headache	1	1.3%
10.	Wheezing sound	3	4%
11.	Burning in eyes	1	1.3%
12.	Poor feeding	8	10.6%
13.	Sputum	3	4%
14.	Sputum with vomiting	2	2.6%
15.	Vomiting after each meal	1	1.3%

The above table depicts that maximum of the 32% (24) children have suffered with running nose, about 32% (24) children have suffered with watery eyes. Only 1.3% (1) children have suffered with burning in eyes, vomiting after each meal and headache.

Table 4: Frequency and percentage distribution of activities noticed in the children during upper respiratory tract infections. n= 75

(Multiple responses)

S. No.	Activities of child during upper respiratory tract infections	Number of samples (frequency)	%
1.	Intermittent crying	19	25.3%
2.	Lethargy	21	28%
3.	Fatigue	9	12%
4.	Loss of appetite	11	14.6%
5.	Sleep disturbance due to nasal congestion	14	18.6%
6.	Not able to mingle with children or others	20	26.6%
7.	Not playing with other children	15	20%
8.	During this time she/he always sit on my lap	8	10.6%
9.	Poor feeding	7	9.3%
10.	Vomiting	7	9.3%
11.	Irritation	10	13.3%
12.	Headache/body pain	2	2.6%
13.	Not remember	1	1.3%

The above table shows that the maximum of the 28% (21) mothers noticed lethargy, about26.6 (20) mothers noticed child not able to mingle with children or others. 25.3% (19) mothers observed intermittent crying. About 2.6% (2) mothers were noticed headache and body pain and only 1.3% (1) mothers was not observed any symptoms during upper respiratory tract infections.

Fig. 1: Percentage distribution of improvement in symptoms of upper respiratory tract infections after home remedies: n = 75

Figure 1: Pie diagram showing improvement in the children when home remedies are initiated.

The above figure shows that majority of the 78% (58) mothers noticed improvement in their child as they started administration of home remedies, while only 22% (17) mothers did not noticed any improvement.

Table 5: Frequency and Percentage Distribution of first Improved Symptoms n=75

Sr. No.	Improved symptoms observed by mothers	Number of samples (frequency)	%
1.	Dry cough	6	8%
2.	Running nose	6	8%
3.	Watery eyes	4	5.3%
4.	Nasal congestion	17	22.6%
5.	Sneezing	3	4%
6.	Grunting sound	6	8%
7.	Throat pain/irritation	24	32%
8.	Relieved from cough at night	4	5.3%
9.	Sputum reduce	3	4%
10.	No relieve	5	6.6%
11.	Not remember	7	9.3%

The above table depicts that the maximum 32% (24) mothers mentioned throat pain/irritation were improved, about 22.6% (17) mothers observed nasal congestion were improved after using home remedies. 5.3% (4) of the mothers mentioned cough were improved and only 4% (3) of the mothers stated sneezing were improved after using home remedies.

Table 6: Frequency and percentage distribution of additional home remedies: n = 75

Sr. No.	Added remedies in the food by the mothers	No. of samples (frequency)	%
1.	Cinnamon	1	1.3%
2.	Jayfal	7	9.3%
3.	Curry leaves	1	1.3%
4.	Black cardamom	5	6.6%
5.	Ajwaain	4	5.3%
6.	Eucalyptus leaves	3	4%
7.	Harad	3	4%
8.	Muleti	3	4%
9.	Arrowroot	3	4%
10.	The harad mix in mustard oil	1	1.3%
11.	Mothers did not use any additional food as remedy	44	58.6%

Above table depicts that the majority ofthe58.6% (44) mothers did not use any type of additional food or separately prepared food as remedy during the episodes of upper respiratory tract infections, but 9.3% (7) mothers were using nutmeg. About 1.3% (1) of the mother was using cinnamon and curry leaves in food preparation.

Table 7: Frequency and percentage distribution of time duration to recover the symptoms n = 75

Sr. No.	Time duration	Numbers of sample (Frequency)	%
1.	Two days	2	3%
2.	Three days	8	11%
3.	Four days	22	29%
4.	Five days	5	7%
5.	Six days	22	29%
6.	One week	14	18.6%
7.	Forgot	2	2.6%

The above table shows that majority 29% (22) of the mothers have mentioned four days and 29% (22) of the mothers reported six days to recover the symptoms of upper respiratory tract infections. About 3% (2) of the mothers have mentioned two days and only 2.6% (2) of the mothers did not remembered time duration of recovery.

The above figure shows that most of the 42% (31) mothers were using home remedies four times in a day and 38.6% (29) mothers were using home remedies thrice. Only 2.6% (2) of the mothers were using home remedies twice.

Table 8: Frequency and percentage distribution of duration of using home remedies n = 75

S. No.	Duration of using home remedies	Number of sample (frequency)	%
1.	3days	6	8 %
2.	4days	17	22%
3.	5days	32	43%
4.	6days	12	16%
5.	7days	8	11%

The above table depicts that majority 43% (32) of the mothers were using home remedies in five days, maximum of the 22% (17) mothers were using four days. About 11% (8) mothers were using seven days and most of the 8% (6) mothers were using home remedies in three days.

Fig 3: Percentage distribution of effects of home remedies. n = 75

Fig 3: Effects of home remedies.

The above figure shows that majority 65.4% (49) of the mothers were observed positive effects and 34.6 % (26) mothers were not observed any effects of home remedies.

Section 3: Description on reasons for resorting to home remedies.

Table 9: Frequency and percentage distribution of reason for resorting n =75

S. No.	Items	Frequency	%
1.	Home remedies do not have side effects	05	6.6%
2.	Home remedy is low cost treatment	07	9.4%
3.	Home remedies are easily available	14	18.6%
4.	Cultural believes regarding that particular home remedy	02	2.7%
5.	Lack of availability and accessibility of hospitals and health care providers	04	5.4%
6.	Home remedies are advised by the elder family members	27	36%
7.	Previous experiences were positive	14	18.6%
8.	Others are also using same home remedies in the locality	02	2.7%
9.	Total percentage		100%

The above table shows that majority 36% (27) of the mothers stated that the home remedies were advised by the elder members in the family. About 18.6% (14) of the mothers mentioned that the home remedy is easily available. 2.7% (2) mother’s mentioned that they were having cultural believes regarding that particular home remedies and only 2.7% (2) mothers stated that the same home remedies were also using in the locality.

Section 3: Relevance of commonly used home remedies in Ayurvedic System of Medicine:

As seen from the study findings Ayurvedic remedies have relevant in managing the upper respiratory tract infections in under five age group children. In order to ascertain and evaluate the relevance of these home remedies according to the Sciences of Ayurveda, the researcher consulted the Ayurvedic experts and got written comments from these consultants regarding the listed home remedies, based on the findings of this study.

CONCLUSION:

The purpose of the present study was to identify the effectiveness of home remedies being used by the mothers of under five children in the management of upper respiratory tract infections.

The study found that out of 75 mothers, 58 (78%) mothers that home remedies were effective. The various types of home remedies, were based on combinations of 22 items out of which they were commonly used 3 to 4 items in verity of combinations such as (Ginger, honey, harad, black pepper, tulsi leaves) etc. The remedies being used by the mothers were verified to ensure how far these were relevant according to Ayurveda. All the remedies being used by the mothers were validated by the Ayurvedic doctor as relevant according to Science of Ayurvedic System of Medicine.

REFERENCE:

1. Dutta P. Text Book of Pediatric Nursing. 2nd Edition. Delhi: published by Jaypee Brothers Medical Publishers (p) Ltd; 2013.273 to 275p.

2. Kiefer. D.2016. Ayurvedic Treatment. Available form: https:// www.webmd.com/balance/guide/Ayurvedic treatment.