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New Research Finds Gap in Diarrhea Care of African Children

Hassana Ousmane rHassana Ousmane rests her head against the bed where 21-month-old Zeinab, suffering from diarrhea, rests, Princess Marie Louise Children's Hospital, Accra, April 25, 2012.sts her head against the bed where her 21-month-old daughter Zeinab
New research recently published online by the American Society of Tropical Medicine and Hygiene finds that young children suffering from diarrheal diseases are less likely to receive life-saving oral rehydration therapy (ORT) when seeking treatment in private clinics.

This first-ever, large-scale study of child diarrhea treatment practices in sub-Saharan Africa found that closing the gap between public and private clinics with regard to access to ORT could each year save the lives of 20,000 children under 5 years of age.

The nine-year study followed the treatment received by 19,000 children in 29 African nations and found that one-fourth of all of the patients sought treatment at private clinics which are less likely to offer the simple inexpensive therapy. The study found that in sub-Saharan Africa, Chad was the only country where private clinics did better in providing ORT over public clinics.

Zachary Wagner, a co-author of the study, described two factors that motivated the study.

“The first is that there are hundreds of thousands of children that die from diarrhea each year,” said Wagner, who is a doctoral student in public health at the University of California-Berkeley. “And this is particularly tragic because there is a very effective and very cheap treatment for diarrhea that prevents death. It’s called oral rehydration salts, (ORS), or oral rehydration therapy.”

ORT is effective because it basically prevents the dehydration caused by diarrhea, which is usually what kills the child.

“This treatment is just widely under-used. That’s why so many children continue to die. It’s been around since the 60s, yet it is still widely under-used,” Wagner noted.

Private clinics grow in popularity

The fact that so many children with diarrhea and diarrheal diseases seek treatment at private clinics was another motivation for the study.

“The private health sector is becoming more and more prevalent in sub-Saharan Africa, and throughout the developing world,” says Wagner. “So, understanding what kind of care is being provided in the private sector is really important.”

He and the research team set out to understand how care for diarrhea in the private sector compared to care for diarrhea in the public sector.

“We found that ORS - this really important treatment - was way less likely to be provided in the private sector for child diarrhea, than the public sector,” he explained.

Wagner says oral rehydration salts are widely available and distributed to developing countries. It is a well-known treatment among development organizations such as the World Health Organization, and NGOs that have promoted the use of the inexpensive and life-saving therapy for treating diarrhea. There is no reason why private clinics should not be using ORT.

“If a child has diarrhea, it is important that the mother or caretaker, takes them to a provider. So, ORS is really important, and it’s really cheap. And they can access it themselves, but it is important to understand how to use it.”

The researcher highlighted the important role private health care providers are now playing in sub-Saharan Africa, and a simple solution of salt packets is a major solution to child mortality. He also said parents and caregivers must make sure children with diarrhea get the care they need to survive.

“So, they should definitely seek care. And they should always give their child this ORS. The World Health Organization recommends that all children with diarrhea, regardless of illness severity, receive this solution after every loose stool,” said Wagner.