Integrated Management of Neonatal and Childhood Illnesses- A cost-effective intervention for controlling diarrhoea: Community based study conducted in rural India.

Abstract

Background: One in every four deaths in children below the age of 5 years is estimated to be due to diarrhoea. One out of every ten babies born in developing countries fails to reach their fifth birthday, falling victim to diarrhoeal diseases. Diarrhoea kills more young children than AIDS, malaria and measles combined. This study explores the cost-effectiveness of integrating immunization, reproductive and child health, and behavioural change under one roof as Integrated Management of Neonatal and childhood illnesses in controlling diarrhoeal diseases. Methods: Five hundred and ten children below the age of 5 years were selected by cluster sampling method (30 clusters, 17 chil-dren in each cluster). Background information was collected from the mother or caretaker of child using a structured questionnaire. Observational checklist was used for assessing environmental con-ditions. A child below five years of age with acute diarrhoea either in the previous two weeks or at the time of interview was considered as a case of diarrhoea. Results: The prevalence of diarrhoea was 20.7%. There was no statistically significant difference in prevalence of diarrhoea in males and females. Among various age groups 7-12 months had highest prevalence of diarrhoea (37.2%) followed by 13-24 months (22.4%). The occurrence of diarrhoea was significantly associated with poor educational status of mother, low birth weight, history of measles, not receiving vitamin A prophylaxis in last 6 months, not gaining weight adequately, poor breast feeding practices, and poor hygiene. Conclusion: One in five children was affected by diarrhoea. Weaning period was found to be the most crucial time. Low awareness among illiterate mothers, incomplete immunization, under-weight, inappropriate breast feeding practices, poor envi-ronmental conditions increase the susceptibility to diarrhoea. A lot of necessary information is already available about effective man-agement of diarrhoea. However, there is lack of critical knowledge & expertise for ensuring accessibility to treatment by those who need it the most. If childhood diarrhoea is not addressed urgently, the countries will fail to achieve the fourth Millennium Development Goal (MDG4) target of reducing child deaths by two-thirds by 2015.