TY - JOUR
T1 - Diarrhea management in children under five in sub-Saharan Africa
T2 - Does the source of care matter? A Countdown analysis
AU - Carvajal-Vélez, Liliana
AU - Amouzou, Agbessi
AU - Perin, Jamie
AU - Maïga, Abdoulaye
AU - Tarekegn, Hayalnesh
AU - Akinyemi, Akanni
AU - Shiferaw, Solomon
AU - Young, Mark
AU - Bryce, Jennifer
AU - Newby, Holly
N1 - Funding Information:
This work was funded through a sub-grant from the U.S. Fund for UNICEF under the [5] for Maternal, Newborn and Child Survival grant from the Bill & Melinda Gates Foundation, Grant #OPP1058954.
Funding Information:
This work was supported by [5] for Maternal, New-born and Child Survival (“Countdown”) with the goal of generating new information useful in increasing the effectiveness of programs aimed at reducing child deaths from diarrhea. Countdown is a global initiative that tracks progress in achieving high, sustained and equitable coverage for interventions of proven effectiveness in preventing unnecessary deaths among women and children in 75 priority countries [5].
Publisher Copyright:
© 2016 The Author(s).
PY - 2016/8/19
Y1 - 2016/8/19
N2 - 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.
AB - 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.
KW - Child health
KW - Diarrhea
KW - Health providers
KW - Household surveys
KW - Oral rehydration salts
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U2 - 10.1186/s12889-016-3475-1
DO - 10.1186/s12889-016-3475-1
M3 - Article
C2 - 27538438
AN - SCOPUS:84982311314
SN - 1471-2458
VL - 16
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 830
ER -