oral rehydration & continued feeding mics 3 data analysis and report writing
TRANSCRIPT
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