Maternal Perceptions and Practices in Trachoma Prevention: A Descriptive and Correlational Analysis Using the Health Belief Model in Rural Ethiopia

Background and Aims: Trachoma remains a leading cause of preventable blindness in Ethiopia, where maternal preventive practices are critical for interrupting transmission. However, the psychosocial and perceptual landscape shaping these practices in high-burden rural communities is poorly characterized. This study describes maternal health beliefs and examines their correlational structure using the Health Belief Model (HBM) to inform the content and delivery of health education.

Methods: A community-based cross-sectional study was conducted in June 2022 in the Andabet district, Northwest Ethiopia, involving 624 mothers with children under nine. Data was collected via face-to-face interviews using a validated HBM-based questionnaire. The analysis included descriptive statistics of socio-demographics and HBM constructs, as well as a Pearson correlation matrix to explore the relationships between perceived susceptibility, severity, benefits, barriers, self-efficacy, and prevention practices.

Results: Nearly half (49.5%) of mothers reported good trachoma prevention practices. Descriptive analysis revealed a high perceived severity (mean = 0.97, SD = 0.02) and strong belief in benefits (mean = 0.85, SD = 0.06), but moderate perceived susceptibility (mean = 0.65, SD = 0.20) and self-efficacy (mean = 0.68, SD = 0.21). A critical knowledge gap was identified, with only 38.5% recognizing flies as a transmission vector. Correlation analysis revealed negligible linear relationships between individual HBM constructs and prevention practices (all |r| < 0.1), as well as weak inter-construct correlations, suggesting independent, non-linear influences on behavior.

Conclusion: While mothers recognize trachoma's severity and value prevention, specific knowledge gaps and moderate self-efficacy levels persist. The lack of strong linear correlations highlights the complexity of health behavior, indicating that improving practices requires more than simply raising awareness. Health education must be multi-faceted, targeted, and designed to address specific misconceptions (e.g., fly transmission) while bolstering personal confidence and competence in performing preventive actions within resource-constrained realities.

© 2026 The Author(s).