M.MED- Family Medicine / Background Oral rehydration therapy (ORT) has been used for many decades, and its usefulness in the management of dehydration caused by diarrhoea is well established. On the other hand, childhood mortality from diarrhoea, is reportedly high in most developing countries. Improved case management of children with diarrhoea, adequate maternal and caregiver’s knowledge on correct preparation, administration and use of oral rehydration solution, are seen as important interventions that could assist in addressing the problem. Aim and Objectives The aim of the study was to assess knowledge and skills of mothers and caregivers in the preparation and use of Salt Sugar Solution (SSS) at Mofolo Community Health Centre (CHC), Soweto. The study objectives were as follows: 1. To determine the proportion of caregivers that had ever-been-taught how to prepare SSS. 2. To assess knowledge of mothers and caregivers’ on the correct use of SSS, including signs of dehydration and danger signs in the Integrated Management of Childhood Illness (IMCI). 3. To determine the proportion of caregivers who demonstrate correct preparation of SSS. Method The study was conducted in the well-baby and general clinic of Mofolo Community Health Centre in Soweto where 407 mothers and caregivers were conveniently sampled, interviewed and asked to practically demonstrate how they prepare SSS. The proportion of mothers and caregivers who were: a) ever-taught; b) knew how to correctly prepare SSS; had the new road to health card and knew signs of dehydration were determined. The chi-square test was used to determine the association between demographic characteristics and the main outcome measure, (correct preparation of SSS). Logistic regression analysis was used to determine the strengths of associations of different variables in relation to the outcome variable (correct preparation of SSS). Results Only 21% of mothers and caregivers could correctly prepare SSS. Less than half (45.7%) had the new road to health card containing correct preparation instructions. Only 7.6% of the 45.7% with the new road to health card, demonstrated how to correctly prepare SSS. A small proportion (2%) of participants said they were never taught how to prepare SSS, while, 55.6% had been taught by healthcare workers. In the category of household income, the largest group, 25.3% of participants had an income between South African Rands (R) 1000 and 2999. Male participants were only 4.9%. About 79% of participants knew at least one sign of dehydration. The chisquare test was used to determine the main outcome measure, which was correct preparation of SSS and demographic factors. Factors associated with correct preparation of SSS were; a) number of teaching sessions received, p-value = 0.0001; b) teaching done by healthcare worker, p-value = 0.0001; c) perceived knowledge of mothers or caregiver on how to correctly prepare SSS, p-value = 0.015; and d) number of children in the household, p-value = 0.011. Conclusion Overall, 79% of mothers and caregivers did not correctly prepare SSS, despite 97% of participants agreeing to having been taught how to prepare SSS. Over half (55.6%) of mothers and caregivers were taught by healthcare worker, however, incorrect SSS use in over half (57.8%) of mothers and caregivers as well as inability to recognize at least one sign of dehydration gave credence to general poor knowledge and use of SSS which is a threat to management of diarrhoeal diseases and overall child mortality and morbidity. / MT2017