Parental Knowledge of Danger Signs in Sick Children and Its Influence on Care-Seeking in Enugu State, South East Nigeria

Early recognition of danger signs in sick children and prompt care-seeking are pivotal in reducing paediatric mortality. This descriptive cross-sectional study evaluates parental knowledge of WHO-defined childhood danger signs and examines how this knowledge influences care-seeking behaviour in Enugu State, South East Nigeria. A total of 340 parents attending child welfare clinics across four healthcare facilities in Enugu and Igbo-Eze North local government areas were recruited. Data were collected using a structured questionnaire covering knowledge of convulsions, fast breathing, inability to feed, lethargy, and persistent vomiting as danger signs. The questionnaire also captured previous care-seeking experiences and healthcare utilisation patterns. Results showed that only 29.4% of respondents demonstrated comprehensive knowledge of at least four of the five WHO danger signs. Convulsions were the most widely recognised danger sign (82.6%), while inability to breastfeed was the least recognised (34.8%). Adequate knowledge was significantly associated with prompt formal care-seeking within 24 hours (p less than 0.01). Factors associated with poor knowledge included low educational attainment, rural residence, and limited health facility contact. The study emphasises the critical role of health education during routine child welfare contacts and recommends structured danger sign counselling as a core component of paediatric outpatient services. Keywords: danger signs, parental knowledge, care-seeking, child health, Enugu State.