User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

Diarrhea management in children under five in sub-Saharan Africa: does the source of care matter? A Countdown analysis

Primary tabs

download
  • Open access
  • PDF
  • 2.52 M
Carvajal-Vélez, Liliana [United Nations Children’s Fund, Unicef New York] Amouzou, Agbessi [United Nations Children’s Fund, Unicef New York] Perin, Jamie [Johns Hopkins University, International Health] Maïga, Abdoulaye [UCL] Tarekegn, Hayalnesh [United Nations Children’s Fund, Unicef New York] Newby, Holly [United Nations Children’s Fund, Unicef New York]

Background Diarrhea remains a high burden disease, responsible for nine percent of deaths in children under five globally. We analyzed diarrhea management practices in young children and their association with the source of care. Methods We used Demographic and Health Survey data from 12 countries in sub-Saharan Africa with high burdens of childhood diarrhea. We classified the quality of diarrhea management practices as good, fair, or poor based on mothers’ reports for children with diarrhea, using WHO/UNICEF recommendations for appropriate treatment. We described the prevalence of diarrhea management by type and assessed the association between good management and source of care, adjusting for potential confounders. Results Prevalence of good diarrhea management is low in 11 of the 12 analyzed surveys, varying from 17 % in Cote d’Ivoire to 38 % in Niger. The exception is Sierra Leone, where prevalence of good practice is 67 %. Prevalence of good management was low even among children taken to health facilities [median 52 %, range: 34–64 %]. Diarrhea careseeking from health facilities or community providers was associated with higher odds of good management than care from traditional/informal sources or no care. Careseeking from facilities did not result systematically in a higher likelihood of good diarrhea management than care from community providers. The odds of good diarrhea management were similar for community versus facility providers in six countries, higher in community than facility providers in two countries, and higher in facility than in community providers in four countries. Conclusion Many children’s lives can be saved with correct management of childhood diarrhea. Too many children are not receiving adequate care for diarrhea in high-burden sub-Saharan African countries, even among those seen in health facilities. Redoubling efforts to increase careseeking and improve quality of care for childhood diarrhea in both health facilities and at community level is an urgent priority.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2016
Language Anglais
Journal information "BMC Public Health" - Vol. 16, no.830, p. 1-14 (2016)
Peer reviewed yes
Publisher BioMed Central Ltd. (London)
issn 1471-2458
e-issn 1471-2458
Publication status Publié
Affiliations United Nations Children's Fund - Unicef New York
Johns Hopkins University - International Health
UCL - SSH/IACS - Institute of Analysis of Change in Contemporary and Historical Societies
Obafemi Awolowo University - Ile Ife
Addis Ababa University - School of Public Health
Keywords Child health ; Diarrhea ; Household surveys ; Health providers ; Oral rehydration salts
Links
  1. Andersen Ronald M., Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?, 10.2307/2137284
  2. Bryce Jennifer, Arnold Fred, Blanc Ann, Hancioglu Attila, Newby Holly, Requejo Jennifer, Wardlaw Tessa, , Measuring Coverage in MNCH: New Findings, New Strategies, and Recommendations for Action, 10.1371/journal.pmed.1001423
  3. Carter E, Bryce J, Perin J, Newby H. Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review. BioMed Central. 2014, In Press.
  4. Colvin Christopher J., Smith Helen J., Swartz Alison, Ahs Jill W., de Heer Jodie, Opiyo Newton, Kim Julia C., Marraccini Toni, George Asha, Understanding careseeking for child illness in sub-Saharan Africa: A systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria, 10.1016/j.socscimed.2013.02.031
  5. Countdown to, 2015. ‘Countdown to 2015 for Maternal, Newborn and Child Survival. 2015. Available at http://www.countdown2015mnch.org/ ’, Accessed 15 May.
  6. Diaz Theresa, George Asha S, Rao Sowmya R, Bangura Peter S, Baimba John B, McMahon Shannon A, Kabano Augustin, Healthcare seeking for diarrhoea, malaria and pneumonia among children in four poor rural districts in Sierra Leone in the context of free health care: results of a cross-sectional survey, 10.1186/1471-2458-13-157
  7. Demographic and Health Surveys, DHS (2010–2014) for Burkina Faso 2010, Burundi 2010, Cameroon 2011, Cote d’Ivoire 2011–12, Democratic Republic of the Congo 2013–14, Ethiopia 2011, Mali 2012–13, Niger 2012, Nigeria 2013, Sierra Leone 2013, United Republic of Tanzania 2010, and Uganda 2011, ICF International, Calverton Maryland USA
  8. Walker C. L. F., Taneja S., LeFevre A., Black R. E., Mazumder S., Appropriate Management of Acute Diarrhea in Children Among Public and Private Providers in Gujarat, India: A Cross-Sectional Survey, 10.9745/ghsp-d-14-00209
  9. Walker Christa L Fischer, Rudan Igor, Liu Li, Nair Harish, Theodoratou Evropi, Bhutta Zulfiqar A, O'Brien Katherine L, Campbell Harry, Black Robert E, Global burden of childhood pneumonia and diarrhoea, 10.1016/s0140-6736(13)60222-6
  10. Health Poverty Action HPA. Sierra Leone’s free Healthcare initiative. 2012. http://www.healthpovertyaction.org/wp-content/uploads/downloads/2012/07/SierraLeoneFHIbriefingweb12.pdf
  11. Gilroy KE, Callaghan-Koru JA, Cardemil CV, et al., on behalf of the CCM-Malawi Quality of Care Working Group. (2012). Quality of sick child care delivered by Health Surveillance Assistants in Malawi. Health Policy Plan. 2013;28(6):573–85.
  12. Liu Li, Oza Shefali, Hogan Daniel, Perin Jamie, Rudan Igor, Lawn Joy E, Cousens Simon, Mathers Colin, Black Robert E, Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis, 10.1016/s0140-6736(14)61698-6
  13. Mediratta RP, Feleke A, Moulton LH, Yifru S, Sack RB. Risk factors and case management of acute diarrhoea in North Gondar Zone, Ethiopia. J Health Popul Nutr. 2010;28(3):253–63.
  14. Miller Nathan P., Hazel Elizabeth, Victora Cesar G., Legesse Hailemariam, Black Robert E., Degefie Tedbabe, Tafesse Mengistu, Amouzou Agbessi, Bryce Jennifer, Integrated Community Case Management of Childhood Illness in Ethiopia: Implementation Strength and Quality of Care, 10.4269/ajtmh.13-0751
  15. Munos Melinda K., Walker Christa L Fischer, Black Robert E, The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality, 10.1093/ije/dyq025
  16. Perin Jamie, Carvajal-Velez Liliana, Carter Emily, Bryce Jennifer, Newby Holly, Fluid curtailment during childhood diarrhea: a countdown analysis, 10.1186/s12889-015-1878-z
  17. Saha Debasish, Akinsola Adebayo, Antonio Martin, Levine Myron M., Adeyemi Mitchell O., Kotloff Karen L., Imran Sayeed, Hossain Mohammad J., Hill Philip C., Jasseh Momodou, Nasrin Dilruba, Sharples Katrina, Health Care Utilization and Attitudes Survey: Understanding Diarrheal Disease in Rural Gambia, 10.4269/ajtmh.12-0751
  18. UNICEF. Sierra Leone Health Facility Survey 2014 - Assessing the impact of the EVD outbreak on health systems in Sierra Leone - Survey conducted 6–17 October 2014. 2014
  19. UNICEF. ‘Global databases based on Multiple Indicators Cluster Surveys, Demographic and Health Surveys and other nationally representative sources.’2015a. Accessed May 2015. (New York.).
  20. UNICEF. ‘Multiple Indicator Cluster Surveys website. 2015b. www.data.unicef.org ’, Accessed 10 June 2015.
  21. WHO-CHERG. ‘Estimates for child causes of death 2000–2013. 2014. http://www.who.int/healthinfo/global_burden_disease/estimates_child_cod_2013/en/ .
  22. WHO/UNICEF. Joint stament: clinical managent of acute diarrhea. Geneva: WHO; 2004.
  23. Wilson SE, Morris SS, Gilbert SS. Sierra Leone ORS case study. Seattle, 2012. Available from: http://www.shopsproject.org/sites/default/files/resources/Sierra%20Leone_ORS%20Case%20Study.pdf . Accessed 30 July 2015.
  24. Wilson Shelby E., Morris Saul S., Gilbert Sarah Skye, Mosites Emily, Hackleman Rob, Weum Kristoffer L.M., Pintye Jillian, Manhart Lisa E., Hawes Stephen E., Scaling up access to oral rehydration solution for diarrhea: Learning from historical experience in low– and high–performing countries, 10.7189/jogh.03.010404
  25. Yansaneh Aisha I., Moulton Lawrence H., George Asha S., Rao Sowmya R., Kennedy Ngozi, Bangura Peter, Brieger William R., Kabano Augustin, Diaz Theresa, Influence of community health volunteers on care seeking and treatment coverage for common childhood illnesses in the context of free health care in rural Sierra Leone, 10.1111/tmi.12383
Bibliographic reference Carvajal-Vélez, Liliana ; Amouzou, Agbessi ; Perin, Jamie ; Maïga, Abdoulaye ; Tarekegn, Hayalnesh ; et. al. Diarrhea management in children under five in sub-Saharan Africa: does the source of care matter? A Countdown analysis. In: BMC Public Health, Vol. 16, no.830, p. 1-14 (2016)
Permanent URL http://hdl.handle.net/2078.1/177433