and Progress: Achieving Goals for Children
a UNICEF report
Diarrhoeal Diseases: Rehydration Saves More Children
Problem: Over 3 million children under five in the developing world — one in four — die from diarrhoeal diseases, mainly from dehydration, which could be prevented by oral rehydration therapy (ORT). Even when diarrhoea is less serious, repeated bouts weaken small children and contribute to protein-energy malnutrition.
Promise: By mid-decade, achieve at least 80 per cent usage of ORT and continued feeding, and by the year 2000, reduce the diarrhoeal death rate among children under five by half and the diarrhoeal incidence rate by a quarter.
Progress: A dramatic improvement in home management of diarrhoea took place between 1990 and 1995, saving about 1 million children annually. In 1990, oral rehydration salts (ORS) or recommended home fluids
(RHF) — the foundation of ORT — were probably used in about a third of diarrhoea cases, and by mid-decade the average was 85 per cent among 33 reporting countries that account for almost half of the world's under-five population. Use of ORS or RHF is not the whole story, however. Since the mid-decade goal was set, it has been recognized that simply increasing fluids is as important in preventing dehydration as the nature of the fluids, as long as feeding continues. Knowledge and practice of this important aspect of ORT, low in 1990, still trail use of ORS and
Prognosis: Without continued commitment and resources, progress
already achieved will come to a halt or even be reversed. Training and
mobilization of political leaders and health professionals and close
attention to communication messages emphasizing ORT and continued feeding
are needed, as are efforts to reduce the incidence of diarrhoea itself,
such as increasing safe water and sanitation and promoting breastfeeding.