Measuring Coverage in MNCH: Current Indicators for Measuring Coverage of Diarrhea Treatment Interventions and Opportunities for Improvement

Diarrhea morbidity and mortality remain important child health problems in low- and middle-income countries. The treatment of diarrhea and accurate measurement of treatment coverage are critical if child mortality is going to continue to decline. In this review, we examine diarrhea treatment coverag...

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Veröffentlicht in:	PLoS medicine Jg. 10; H. 5; S. e1001385
Hauptverfasser:	Fischer Walker, Christa L., Fontaine, Olivier, Black, Robert E.
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Public Library of Science 01.05.2013 Public Library of Science (PLoS)
Schlagworte:	Breastfeeding & lactation Caregivers Child Child Health Services - standards Child Mortality Child, Preschool Children Children & youth Developing Countries Diarrhea Diarrhea - diagnosis Diarrhea - mortality Diarrhea - therapy Epidemiology Family Characteristics Fluid Therapy - standards Global Health Guideline Adherence Health aspects Health Care Surveys - standards Health promotion Health Services Accessibility Health Services Needs and Demand Health Services Research - methods Health Services Research - standards Households Humans Infant Infant, Newborn LDCs Low income groups Management Medicine Morbidity Mortality Patient Acceptance of Health Care Physiological aspects Practice Guidelines as Topic Practice Patterns, Physicians Prevalence Prevalence studies (Epidemiology) Program Evaluation Quality Improvement Quality Indicators, Health Care - standards Research Design Review Social aspects Surveys and Questionnaires Time Factors Treatment Outcome Zinc - therapeutic use Switzerland Fluid Therapy Prevalence Humans Child, Preschool Infant Health Services Research Child Mortality Physician's Practice Patterns Child Health Services Time Factors Health Services Accessibility Questionnaires World Health Child Infant, Newborn Quality Indicators, Health Care Diarrhea Treatment Outcome Zinc Health Services Needs & Demand Family Characteristics Guideline Adherence Patient Acceptance of Health Care Quality Improvement Developing Countries Program Evaluation Research Design Health Care Surveys Practice Guidelines as Topic
ISSN:	1549-1676, 1549-1277, 1549-1676
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Zusammenfassung:	Diarrhea morbidity and mortality remain important child health problems in low- and middle-income countries. The treatment of diarrhea and accurate measurement of treatment coverage are critical if child mortality is going to continue to decline. In this review, we examine diarrhea treatment coverage indicators collected in two large-scale community-based household surveys--the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). Current surveys do not distinguish between children with mild diarrhea episodes and those at risk for dehydration. Additional disease severity questions may improve the identification of cases of severe diarrhea but research is needed to identify indicators with the highest sensitivity and specificity. We also review the current treatment indicators in these surveys and highlight three areas for improvement and research. First, specific questions on fluids other than oral rehydration salts (ORS) should be eliminated to refocus the treatment of dehydration on ORS and to prevent confusion between prevention and treatment of dehydration. Second, consistency across surveys and throughout translations is needed for questions about the caregiver behavior of "offering" the sick child fluid and food. Third, breastfeeding should be separated from other fluid and food questions to capture the frequency and duration of nursing sessions offered during the illness. Research is also needed to assess the accuracy of the current zinc indicator to determine if caregivers are correctly recalling zinc treatment for current and recent diarrhea episodes.
Bibliographie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 The authors have declared that no competing interests exist. Wrote the first draft of the manuscript: CLFW. Contributed to the writing of the manuscript: REB OF. ICMJE criteria for authorship read and met: CLFW REB OF. Agree with manuscript results and conclusions: CLFW REB OF.
ISSN:	1549-1676 1549-1277 1549-1676
DOI:	10.1371/journal.pmed.1001385