Oral Rehydration & Continued Feeding

MICS 3 Data Analysis and Report Writing

Background

• Diarrhea is the second leading cause of death among children under five worldwide.

• Most diarrhea-related deaths in children are due to dehydration from the loss of large quantities of water and electrolytes from the body in the liquid stool.

• Many of these deaths can be prevented with the use of oral rehydration therapy (ORT).

Background

Current recommendations for treatment of diarrhea:

Oral Rehydration Therapy [(oral rehydration solution and/or an appropriate household solution) or increased fluids] and continued feeding.

International Goals & Targets

Reduction by 50 percent in the deaths due to diarrhoea in children under the age of five

years and 25 per cent reduction in the diarrhoea incidence rate

List of Indicators

• Prevalence of diarrhea

• Oral rehydration therapy (ORT)

• Home management of diarrhea

• (ORT or increased fluids) and continued feeding

Indicator Issues

• Monitoring indicators have changed several times over the last decade.

• Significant comparability issues, and problems analyzing trends over time.

• Several different indicators therefore continue to be tracked.

• Latest indicator agreed by the interagency child survival indicator meeting, June 2004:

% children aged 0-59 months with diarrhea receiving (ORT or increased fluid) and continued feeding

Definition of Indicator

Prevalence of Diarrhea (2 weeks)% children aged 0-59 months with diarrhea

in the 2 weeks prior to the survey

Numerator: Number of children aged 0-59 months reported to have diarrhea in the 2 weeks prior to the survey

Denominator: Total number of children aged 0-59 months surveyed

Definition of Indicator

Oral Rehydration Therapy% children aged 0-59 months with diarrhea

receiving oral rehydration therapy

Numerator: Number of children aged 0-59 months with diarrhoea receiving oral rehydration (oral rehydration solution and/or an appropriate household solution or taking “more” fluids)

Denominator: Total number of children aged 0-59 months with diarrhea in the previous 2 weeks

Definition of Indicator

Home Management of Diarrhea% children aged 0-59 months with diarrhea

receiving continued feeding

Numerator: Number of children aged 0-59 months with diarrhoea who took more fluids and continued eating somewhat less, the same or more food

Denominator: Total number of children aged 0-59 months with diarrhea in the previous 2 weeks

Definition of Indicator

ORT or increased fluids and continued feeding% children aged 0-59 months with diarrhea

receiving ORT or increased fluids and continued feeding

Numerator: Number of children aged 0-59 months with diarrhoea who received oral rehydration therapy or took more fluids and continued eating somewhat less, the same or more food

Denominator: Total number of children aged 0-59 months with diarrhea in the previous 2 weeks

Methodological Issues

• If the mother/caregiver did not know if the child had diarrhea in the past 2 weeks, the child is omitted from the calculation for oral rehydration treatment and home management.

• Appropriate oral rehydration salts and/or homemade solutions include:– specific packet of ORS (local name)– government recommended homemade solution– pre-packaged ORS fluid for diarrhea

• Percentages of children aged 0-59 months receiving various treatments will not add to 100 since some children will receive more than 1 type of treatment.

Tabulation PlanTable CH.4: Oral Rehydration Therapy

Tabulation PlanTable CH.5: Home Management of Diarrhea

Regional ORT & CF Coverage

Oral Rehydration and Continued Feeding

59

37 3630 26 25

33

0

20

40

60

80

100

East A

sia/ P

acifi

c (e

xcl.

China)

East/S

outh

ern A

frica

Latin

Am

eric

a/ C

arib

bean

West

/Cen

tral

Africa

South A

sia

CEE/CIS

Devel

oping

countri

es (

excl

. Chin

a)

% u

nd

er

fiv

es

wit

h d

iarr

he

a r

ec

eiv

ing

o

ral r

eh

yd

rati

on

an

d c

on

tin

ue

d f

ee

din

g

ORT & CF Coverage (CEE/CIS)

Oral rehydration and continued feeding

25

16

19

22

23

29

33

40

48

51

52

0 20 40 60 80 100

CEE/CIS

Kyrgyzstan

Turkey

Kazakhstan

Bosnia and Herzegovina

Tajikistan

Uzbekistan

Azerbaijan

Armenia

Albania

Moldova, Republic of

% under fives with diarrhea receiving oral rehydration and continued feeding

ORT & CF Coverage (ROSA)Oral rehydration and continued feeding

26

22

33

35

43

48

0 20 40 60 80 100

South Asia

India

Pakistan

Bangladesh

Nepal

Afghanistan

% under fives with diarrhea receiving oral rehydration and continued feeding

ORT & CF Coverage (MENA)

Oral rehydration and continued feeding

23

29

38

44

50

0 20 40 60 80 100

Yemen

Egypt

Sudan

Jordan

Morocco

% under fives with diarrhea receiving oral rehydration and continued feeding

Oral rehydration and continued feeding

36

21

22

28

31

40

41

42

43

44

46

49

51

54

0 20 40 60 80 100

Latin America/Caribbean

Jamaica

Guatemala

Brazil

Trinidad/Tobago

Guyana

Haiti

DR

Suriname

Colombia

Peru

Nicaragua

Venezuela

Bolivia

% under fives with diarrhea receiving oral rehydration and continued feeding

ORT & CF Coverage (TACRO)

ORT & CF Coverage (CEE/CIS)

Oral rehydration and continued feeding

25

16

19

22

23

29

33

40

48

51

52

0 20 40 60 80 100

CEE/CIS

Kyrgyzstan

Turkey

Kazakhstan

Bosnia and Herzegovina

Tajikistan

Uzbekistan

Azerbaijan

Armenia

Albania

Moldova, Republic of

% under fives with diarrhea receiving oral rehydration and continued feeding

30

172325

28

2833333436

3839404243

44444445

4747

50

0 20 40 60 80 100

West/Central Africa

Congo, Dem Rep

Guinea-Bissau

Togo

Mauritania

Nigeria

Cameroon

Senegal

Côte d'Ivoire

Eq. Guinea

Gambia

Sierra Leone

Ghana

Benin

Niger

Gabon

Guinea

Sao Tome/Principe

Mali

Burkina Faso

CAR

Chad

ORT & CF Coverage (WCARO)

% under fives with diarrhea receiving oral

rehydration and continued feeding

ORT & CF Coverage (ESARO)

37

71616

24

292931

3233

3738

3839

47

4748

5154

80

0 20 40 60 80 100

East/Southern Africa

Botswana

Burundi

Rwanda

Swaziland

Lesotho

Uganda

Comoros

Angola

Kenya

South Africa

Ethiopia

Tanzania

Namibia

Madagascar

Mozambique

Zambia

Malawi

Eritrea

Zimbabwe

% under fives with diarrhea receiving oral

rehydration and continued feeding

ORT & CF Coverage (EAPRO)

59

37

39

48

59

61

66

76

0 20 40 60 80 100

East Asia/Pacific(excl. China)

Lao PDR

Viet Nam

Myanmar

Cambodia

Indonesia

Mongolia

Philippines

% under fives with diarrhea receiving oral rehydration and continued feeding