Background: Hand washing with soap is a simple, cost-effective way to prevent disease but is often neglected, leading to the spread of harmful germs. In many households, mothers, responsible for cleaning and feeding, play a crucial role in disease prevention. However, poor knowledge and improper hand hygiene practices can increase the risk of infections, especially for under-five children. About 88% of diarrheal deaths globally are linked to unsafe water, poor sanitation, and inadequate hygiene. Studies show that proper hand washing can significantly reduce diarrheal diseases, respiratory infections, and skin issues, yet these practices remain underutilized, particularly in developing countries.

Methods: This cross-sectional study was conducted in an urban slums area of Sambalpur District, Odisha. Mothers of children under five were briefed on the objectives of the survey, and verbal consent was obtained from each participant. The questionnaire was designed to assess health, hygiene, and sanitation practices.

Results: Out of 550 mothers, 79.45% were from the age group of 20-30 and majority i.e., 81.8% was housewives. 99.02% mothers were aware that unwashed hands can transmit the diseases. Maximum i.e., 95.5% mothers washed hands before eating and 76.4% washed before cooking. All the mothers washed hands after visiting toilet. Most mothers used soap and water (85.3%) for hand washing. Significant numbers of under-fives children suffered from morbidity in last three months (p<0.05).

Conclusion: The study concluded that although mothers are aware of the importance of hand washing, inconsistent hand hygiene practices contribute to increased morbidity among children under five in urban slums.