INTRODUCTION:

Hospital admission in children jeopardizes children’s survival, health, growth and development, and it slows national progress towards development goals. Undernutrition is often an invisible problem.^11,12

A child who is in good health will be happy, active, creative, alert and bright. According to the World Health Organization (WHO), in 2015, 4.5million (75%) of all under five deaths occurred within the 1st year of life and the highest risk was in the WHO Asian and African Region (55/1000 live births). This is over 5 times higher in comparison to the European Region (10/1000 live births).¹ The united- nations children fund (UNICEF) and the ministry of health (MOH), Ghana recommended exclusive breastfeeding for the first six months of the infant’s life and when it does not happen it leads a major cause of under five mortality and morbidity.^7,8,13 Child survival is a very sensitive indicator of population, growth and socio-economic development. Every year about 26 million children are born in our country.^9,10

The under five age group is crucial time for development because children's quick mental, physical and socio- emotional aspects serve as the "building blocks" for their future development. The issue of the child health is multifaceted, with certain regions, especially developing nations, experiencing an alarming rise in under five children mortality and morbidity rates.Progress in reducing these rates in developing countries lags that of developed nations. Disparity in children's survival rates are pronounced worldwide, with developing nations bearing a disproportionate burden. Key contributors to child fatalities include malnutrition, respiratory infection, diarrheal disease, measles, and neonatal complications.^2,3

Assessment, identification and Management of the reasons and risk factors of Hospitalization of children under age five years is an important aspect in prevention of the childhood illness and in promotion of the overall health of the children.^3,4

The world as a whole has accelerated in lowering under five mortalities, differences in under five mortality exist across regions and countries. Nigeria and India both solitary records for nearly a third of all deaths.^15,16Frequents surveys and educating the parents on reasons of mortality and morbidity in children has found to be effective in improving the survival of under five-year children.^14,15

This research aims to identify the primary causes and risk factors for hospital visits (OP) and hospitalization (IP) among children under five years of age at selected Hospital in Salem, focusing on the local context and prevalent health issues within that community. The study will investigate the incidence rate and major factors such as infectious diseases, nutritional status, socioeconomic factors, and access to healthcare as potential contributors to hospital visit and admissions.

ОВЈЕСTIVES OF THE STUDY:

1. To identify the incidence and major reasons for hospital visit (OP) among under five children.

2. To identify the incidence and major reasons for hospitalization (IP) among under five children.

METHODOLOGY:

Theresearchapproachadoptedinthisstudyisquantitativeresearchapproach. The Research design adopted is descriptive design by survey method. Here in this study population refers to children under five years of age. Samplesizeofthestudywas100. Samples were selected by using Nonprobability convenient sampling technique at Sri Gokulam hospital in the year 2024. The closed ended questionnaires was used to assess the incidence and major reasons for hospital visit (OP) and hospitalization (IP) in the last year among under five .Approximately took 30 minutes to complete the survey. The data collected from 100 samples were kept confidential.

RESULTS:

Table 1: Distribution of samples according to demographic variables. n=100

Demographic Variables	Frequency	Percentage
1.Age of the child
a.0-lyears	16	16%
b.1-2years	32	32%
C.2-3years	20	20%
d.^3-4years	16	16%
e.4-5years	16	16%
2. Sex
a. Female	48	48%
b. ^Male	52	52%

The above table shows that the distributions of the under five children according to the age ,that majority 32% were between 1-2 years and least 20% between 2-3 years, children sex shows that majority 52%weremales and rest 48%werefemales.

Table 2: Demographic data according to birth history n=100

1.Nature of delivery a. ^Normal b. LSCS	66 34	66% 34%
2.Gestational Maturity at birth
a. Preterm	5	5%
b. Term	88	88%
c. Postterm	7	7%
3.Birth weight in kg
a. ^{Below 2kg}	1	1%
b.^2-2.5kg	25	25%
C.2.5-3kg	57	57%
d.3kg and above	17	17%
4.Complication During pregnancy
A. Yes	23	23%
B. No	77	77%
If yes,
a. Birthasphyxia	3	13%
b. ^{Meconiumaspiration}	12	52.17%
C. Congenitalanomalies	6	26%
d. Neonataljaundice	2	5%

The above table shows , the nature where the child was delivered, majority 66% normally delivered, gestational maturity at birth majority 88% was term baby and preterm being the least 5%, birth weight majority 57% was between 2.5-3kg, 25% being 2-2.5 kg, above 3kg being 17% and below 2kg being 1% ,presence of any complication during birth of the child, majority was 77% had no complication at all and 23% had complication. Out of 23 samples 52.17% had meconium aspiration 26%,congenitalanomalies 13% had birth asphyxia 5% had other complication.

Table 3: Demographic data according to Immunization status n=100

Demograpidc variables	Frequency	Percentage
1. Immunization Statusuptodate
a. Yes	85	85%
b. No	15	15%

The above table dipicts children immunization status, the majority ofchildren 85% was vaccinated up to date.

Table 4: Demographic data according to attendance to Preschool

n=100

Demograpidc variables	Frequency	Percentage
1.Is the child attending Preschool
a. Yes	47	47%
b. No	53	53%

The table is about admission to preschool, majority 53% children were not attending preschool and only 47% children attending to preschool.

SECTION-B

Table 5: Distribution of samples based on the number of hospital visit (OP) in the last year n=100

No of hospital visit last year	Frequency	Percentage
a. ^{Less than 3times}	13	13%
b. 3-5 times	45	45%
c. Above 5 times	42	42%

The above table shows that among 100 samples majority of samples 45% visited 3- 5 times, 42% above 5 time and less than 3 times13% of samples made hospital visit in the last year.

Table 6: Distribution of samples according to age and the hospital visit (OP) in the last year n=100

Noofhospitalvisit last year	Frequency	Percentage
0-l year
a. Less than 3 times	2	12.5%
b. ^{3-5 times}	9	56.25%
c. ^{More than 5 times}	5	31.25%
1-2year
a. Less than 3 times	2	6.25%
b.^{3-5 times}	18	56.25%
c.More than 5 times	12	37.5%
2-3year
a. Less than 3 times	5	25%
^b.3-5times	7	35%
c. More than 5 times	8	40%
3-4year
a. ^{Lessthan3times}	0	0%
^b.3-5times	7	43.75%
c.More than 5times	9	56.25%
4-5year
a. Less than 3 times	4	25%
^b.3-5times	4	25%
c.Morethan5times	8	50%

The above table shows that among 0-1year, majority of samples 56.25% visited 3-5times. 31.25% samples visited more than 5 times. Least 12.5% were less than 3 times. Among 1-2 year, majority of samples 56.25% visited 3-5 times. 37.5% visited more than 5 times and least were 6.25% visited less than 3 times. Among 2-3 years, majority of samples 40% visited more than 5 times, 35% visited 3-5 times and least 25% visited less than 3 times. Among 3-4 years, majority ofsamples 56.25% visited morethan 5 times. 43.75% visited 3- 5 times and there were no samples visited less than 3 times 0%. Among 4-5 years, majority of samples 50% visited more than 5 times, 25% less than 3 times and 25% 3-5times.

SECTIONC:

Table 7: Distributionofsamples based on number of hospitalization (IP)in the last year n=100

Noof Hospitalization Last year	Frequency	Percentage
a. Less than 2times	49	49%
b.^2-3times	46	46%
C.^Above3times	5	5%

The above table shows that among100 samples majority of samples 49% visited the hospital was lessthan 2 times, 2-3 times 46%, above 3 times 5%.

Table 8: Distribution of samples according to age and the hospitalization (IP) in the last year n=100

No of hospital visit lastyear	Frequency	Percentage
0-lyear
a. Less than 2times	12	75%
b.^{2-3 times}	4	25%
c. Above 3 times	0	0%
1-2year a. Less than 2 times	16	50%
b.2-3 times	12	37.5%
C.Above 3 times	4	12.5%
2-3year
a.Less than 2times	9	45%
b.^2-3times	11	55%
C.Above3times	0	0%
3-4year
a. Less than 2times	5	31.25%
b.^2-3times	10	62.50%
C.Above 3times	1	6.250%
4-5Year
a. Less than 2times	7	43.75%
b.2-3 times	7	43.75%
C.Above 3 times	2	12.5%

The above table shows that among 0-1year, majority of samples 75% were hospitalized less than 2 times and least 25% were hospitalized 2-3 times. There were no samples for above 3 times. Among 1-2 year majority 50% were hospitalized less than 2 times. 37.5% were 2-3 times and least 1-2.5% were hospitalized above 3times. Among 2-3 year, majority 55% were between 2-3 times, 45% were less than 2 times and there were no samples for above 3 times. Among 3-4years, majority 62.50% were hospitalized 2-3 times, 31.25% were less than 2 times and least 6.25% were hospitalized above 3 times. Among 4-5 year, 43.75% samples were hospitalized less than 2 times and 3 times. Least 12.5% were hospitalized 3 times.

Identification of Major Reasons for Hospital Visit (Opd) among under Five Children:

The study shows that among 100 samples majority of samples >70% had visited the hospital with reasons like cough 75%, fever 80%, cold 88%. Lesser number of samples <50% visited hospital for reasons like diarrhoea 49%, breathing difficulty 36%, vomiting 38%, seizure 19%, constipation 15%, minor accidents 5%, poisoning 4%, foreign body aspiration 2% and animal bite 2%. The samples did not visit the hospital for reasons like bums, drowning and others.

The major reason for the hospital visit last year among under five children (0-l year) reveals that majority 100% had cold. Other causes for hospital visit includes cough 62%, fever 50%, diarrhea 43.75%, breathing difficulty 25%, seizure 25%, vomiting l8.75%. The samples did not visit the hospital for reasons like constipation, poisoning, foreign body aspiration, animal bite, burns, drowning, minor accidents and others.

The major reason for the hospital visit last year among under five children (l-2year) reveals that majority 100% had cold. Other causes cough 90.6%, fever 96.8%, diarrhea 50%, breathing difficulty 46.8%, vomiting 31.2%, constipation 12.5% seizure (15.6%). The samples did not visit the hospital for reasons like poisoning, foreign body aspiration, animal bite, bums, drowning, minor accidents and others.

The major reason for the hospital visit last year among under five children (2-3years) reveals that majority 70% had fever. Other causes were cold 60%, cough 60%, diarrhoea 35%, breathing difficulty 40%, vomiting 40%, constipation 20%, poisoning l5%, foreign body aspiration 15%, animal bite l0%, seizure 20%. The samples did not visit the hospital for reasons like burns, drowning, minor accident sand others.

The major reason for the hospital visit last year among under five children (3-4year) reveals that majority 87.5% had fever and cold. other causes were cough 81.5%, diarrhea 68.7%, breathing difficult 31.25%, vomiting 75%, constipation 43.7%, foreign body aspiration 12.5%, seizure (37.5%), bums, poisoning drowning, minor accidents, animal bites, and others.

The major reason for the hospital visit last year among under five children (4-5) reveals that majority 87.5% had cold. Other causes were cough 68.7%, fever 81.5%, diarrhoea 50%, breathing difficulty 25%, vomiting 31.25%, constipation l2.5%, poisoning6.25%, foreign body aspiration 6.25%, seizure 31.5%, minor accidents 6.25%, minor accidents 6.25%, No hospital visit for animal bite, bums, drowning and others.

Identification of Major Reasons for Hospitalization (Ip) Among Under Five Children:

The study shows that among 100 samples, the majority of samples (>40%) were hospitalized for reasons like fever 67%, cold 41%, cough 40%. Lesser number of samples (<20%) were having diarrhoea 17%, seizure 16%, vomiting 12%, anemia 7%, breathing difficulty 6% constipation, animal bite, burns, and minor disorders were 4%. poisoning, foreign body aspiration 2%, Drowning 1%. There were no reasons like surgical intervention and others.

The major reasons for present hospitalization among under five children (0-lyear) reveals that majority 100% had fever. Other causes were cold 18.75%, cough 20%, diarrhoeal 8.75%, breathing difficulty 6.25%, vomiting 18.75%, There were no reasons like constipation, poisoning, foreign body aspiration, animal bites, anemia, surgical intervention, drowning and others.

The major reasons for present hospitalization among under five children (1-2year) reveals that majority 59.3% had fever. Other causes were cold 37.5%, cough 43.75%, breathing difficulty 9.37%, vomiting 21.87%, constipation 3.12%, foreign body aspiration 3.12%, animal bite, seizure l5.62%, burns 6.25%, There were no reasons like poisoning surgical intervention, drowning, and others.

The major reasons for present hospitalization among under five children (2-3year) reveals that majority is 70% had fever, cold, cough. other causes were diarrhoea 10%, vomiting 10%, foreign body aspiration 5%, seizure 25%, minor accidents 15%, anemia 5%. No other reasons like breathing difficulty, constipation, poisoning, animal bite, bums, surgical intervention, drowning and others.

The major reasons for present hospitalization among under five children (3-4year) reveals that majority 75% had fever, cold, cough. Other causes diarrhoeal 2.5%, breathing difficulty 12.5%, constipation 18.7%, poisoning l2.81%, anemia 18.7% drowning 6.25%. No other reasons like vomiting foreign body aspiration, animal bite, seizure, burns, minor accidents, surgical intervention and others.

The major reasons for present hospitalization among under five children (4-5year) reveals that majority 37.5% had fever. Oher causes were diarrhoea 15% bums l2.5%, minor accidents 6.25%, animal bite 4.25%. There were no reasons like cold, cough, breathing difficulty, vomiting, constipation, poisoning, foreign body aspiration, seizure, anemia, surgical intervention, drowning and others.

IMPLICATIONS:

Nursing Practice:

· Health education can be given to parents about home remedies for minor ailments to reduce exaggeration of symptoms and complications among under five children to avoid hospitalization

· Behaviour change communication can be provided to parents to modify the behaviour of under five children (like Hand washing) to prevent infections.

Nursing Education:

· Appropriate teaching and learning material need to be prepared and made available for nurses and nursing students

· Nursing educators should take initiative in organizing continuing education programme for nurses to identify the risk factors among under five children diseases

Nursing Administration:

· The nurse administrator can utilize the finding of study to organize the programme to increase awareness about under five children hospitalization

· Effective inservice education can be given to nurses and healthcare workers to update the knowledge on reasons and risk factors for diseases among under five children

Nursing practice:

· The nursing investigator should be motivated to conduct more about reason and risk factors of hospitalization among under five children.

· Disseminate the findings through conference seminar and publications.

· The nurse researcher can take this study as a baseline to build the further study.

CONCLUSION:

Hospital visit (OP) and hospitalization (IP) both can significantly impact the child and the family, leading to psychological, social, and developmental challenges. Children may experience fear, anxiety, and separation anxiety due to unfamiliar surroundings, medical procedures, and separation from loved ones. Parents may also experience stress, anxiety, feelings of helplessness and care of other children in the family. The entire family routine can be disrupted, leading to financial burdens and changes in family dynamics. Nurses play a crucial role in minimizing the incidence of hospital visit and hospitalization among under five by carrying out frequent health survey and monitoring the growth and by providing supportive education.

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Received on 21.08.2025 Revised on 08.12.2025

Accepted on 13.02.2026 Published on 30.07.2026

Available online from August 05, 2026

Int. J. Nursing Education and Research. 2026;14(3):191-195.

DOI: 10.52711/2454-2660.2026.00038

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