Back ground: Diarrhea is the most common pediatric disease. Drug therapy is unnecessary in most cases, and may even be contraindicated or dangerous because majority of diarrhea cases in children are viral in origin. Most diarrheas can be managed at home and without drugs. The WHO definition of home case management for diarrhea allows for flexibility: begin early use of available food-based fluids (except heavily salted soups or very sweet drinks) and/or give oral rehydration solution (ORS) if available and affordable, continue breastfeeding if the child is breastfed; give frequent and small amounts of food during diarrhea and continue with catch-up feeding for two weeks following the diarrhea episode, recognize danger signs of diarrhea that require immediate care and seek help from an appropriate provider and give zinc supplements (tablets or syrup) for 10-14 days.

Ethiopia is one of the top 15 countries in which nearly ¾ of child death occur due to diarrhea. The vast majority of deaths from diarrhea are among children under 5 years of age living in low and middle income countries including Ethiopia. Early and correct identification of diseases and prompt initiation of management plays a key role in reducing diarrhea related mortality. Increased fluid intake and continued feeding by caregivers especially by mothers are vital measures that prevent diarrhea related child mortality.

Objective: The present study is aimed to investigate the practice of mothers/caregivers on home management of diarrhea in under-five children in Mareka district, Dawuro zone, SNNPR, Ethiopia.

Methods: Community based cross-sectional study was employed from March 1-30, 2016. Multi stage stratified sampling technique was used to select subjects to be included in the study from 11 Kebeles.  Data were collected using pre-tested structured interviewer administered questionnaire.

Results: Total of 654 mothers/caregivers were participated in the study. Most (70.3%) of the mothers/caregivers were in favor of sustained feeding (breast milk, solid and liquid food) during episodes of diarrhea in their children while 194 (29.7%) supported diet withdrawal. The level of practice on home management of diarrhea among respondents was good in 309 (47.2%) respondents and poor in 345 (52.8%) respondents respectively. Only 50 respondents were aware about the correct amount of ingredients of homemade ORS (salt-sugar solution). A significant relationship was found between mothers’ educational level secondary and above, mothers of female index child, average monthly income of the household & mothers residence in urban areas and mothers’ practice. Mothers educated secondary and above had better practice when compared to mothers with lower education. This study also revealed significant difference between sex of an index child and maternal practice. Mothers of female children practice 35% less likely when compared to mothers of male children. Mothers living in urban area had 13 times better practice on home management of diarrhea when compared to mothers living in rural areas.

Conclusion and recommendation: More than half of the respondents have poor practice on home based management of diarrhea. Therefore, strategies to increase practice level of mothers on home management of diarrhea are needed.