Giving Hope to Children with Diarrhoea

Government, Amref Health Africa and Micronutrient Initiative Study Advocates for ORS and Zinc Treatment Kits be delivered to every mother in hard to reach communities using non-health channels

September 29th, 2015. Nairobi, Kenya: - Myths, superstitions and belief in using herbs to treat diarrhea in children under five still persists in Kenya. Such myths and misconceptions concerning diarrhea are part of findings in a study conducted by Amref Health Africa, Micronutrient Initiative and the Kenyan Ministry of Health.

“Diarrhea disease as the second leading cause of death in children under five years old leaves the body without the water and salts that is necessary for survival. It is for this reason that most people who die from diarrhea actually die from severe dehydration and fluid loss,”

says Dr Josephat Nyagero, Principle Investigator and Researcher, Amref Health Africa.

“Some communities believe diarrhea is preventable by use of herbs. We conducted several in-depth interviews with health providers, community leaders and also held focus group discussions and household interviews for mothers in Narok South as a baseline for our study.”

The study entitled, Assessing the delivery mechanisms of distributing ORS and Zinc, and empowerment of mothers/ caregivers in diarrhea management of children under five years old using ORS and Zinc, was conducted in 22 clusters in Narok South Sub-County covering 10,345 km2 with a population of 365,000 including 73,000 children under-five years of age. Eleven of these clusters were randomly assigned to the intervention, the other 11 to the control. A baseline survey was conducted to establish benchmark indicators against which the ORS and Zinc cluster randomized control study end-line project outcome indicators will be compared.

Dr Rachael Nyamai, Head, Neonatal Child and Adolescent Health Unit, Kenya Ministry of Health, adds,

“In Kenya diarrhea contributes to over 20% of under five year old child mortality and severe childhood diarrhea has a case fatality of 21%. Problems exist with the ORS and Zinc supply chain and knowledge and practices of diarrhoea management in communities. Therefore, there is an urgent need for revamping the supply chain system for ORS and Zinc for health facilities and CHV.”

In the baseline survey, all women with children under five years who were usual residents in sampled clusters were eligible to be interviewed and questionnaires were completed for 10,989 children under five years, with 500 children targeted in each cluster. The qualitative aspect of the study showed a widespread influence of tradition on the causes, prevention and management of diarrhea. For example diarrhea is said to be caused by teething in babies, getting pregnant while breast feeding, having too much sex while breast feeding. There is also strong belief in the superiority of traditional therapies and herbs. Some of these herbs are mixed with cream and it is only when they fail that a child is taken to a health facility. The same approach of data collection was repeated during the end-line survey that was held after 12 months of implementing an intervention package in 11 of the 22 study clusters.  

There is also an increase in the proportion of households that cover their drinking water containers between the baseline and end-line. However, water treatment practices remains low and assumed a falling trend during the two surveys which impact negatively to the diarrhoea management. The positive practices such as reduced fetching time and covering drinking water containers are likely to have a good influence to prevention and management of diarrhoea.

Dr Christopher Wanyoike, Country Director, Micronutrient Initiative, said

“the supply chain of essential commodities in diarrhoea management is important and needs to be addressed so that the medicines can be evenly available across the country including the hard to reach parts of the country.”

In conclusion, the study advocated for the initiation of innovative strategies of ensuring mothers across the country have adequate knowledge and access to ORS and Zinc for easy home management of diarrhea in children under five years. The feeding practices and fluid intake during episodes of diarrhea will need to be emphasized during caregiver training. The Kenya Ministry of Health was urged to promote the use of ORS and Zinc.

“Problems exist with the drug supply chain, skills at health facility level, the knowledge and practices in communities. Private sector drug distribution is mostly limited to urban centers. Therefore, there is an urgent need for revamping the drug supply chain system for ORS and Zinc for health facilities and CHVs. Further, mothers and caregivers at the community level need to be empowered to treat children suffering from diarrhea with ORS and Zinc”

concluded Dr Nyagero.

Amref Health Africa implemented the ORS and Zinc cluster randomized controlled study in collaboration with the Ministry of Health and Micronutrient Initiative. The research project and subsequently was financially sponsored by the Micronutrient Initiative and Amref Health Africa.



For further media information contact
Rose Thuo                                                                                  Dinah Karwitha
Communications Manager                                                        Media Assistant
Amref Health Africa in Kenya                                                   Amref Health Africa in Kenya
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Editors Notes

Amref Health Africa an international African organisation in health has been working with the most isolated African communities to achieve lasting health change since 1957. We believe that the power to transform Africa's health lies within her communities. Amref Health Africa works side by side with the people of these communities to build the knowledge, skills and means to transform their health; laying foundations that will be felt for generations to come. Amref Health Africa supports those at the heart of the communities, particularly women and children, to bring about lasting health improvement.

About the ORS and Zinc Baseline Survey Project
Amref Health Africa implemented the ORS and Zinc baseline survey in collaboration with the Ministry of Health and Micronutrient Initiative. The research project and subsequently the baseline survey was financially sponsored by the Micronutrient Initiative and Amref Health Africa.


Preliminary Report for the ORS and Zinc study Narok County
ORS and Zinc mechanisms of delivery to communities