Diarrhea continues to be the second biggest killer of children under five years. Approximately 11% of the 7.6 million child deaths each year are due to diarrheal disease,1 which represents significant reductions over the past years. However, considering that diarrhea is both preventable and treatable with simple and cost-effective interventions, continued work is critical to end these needless child deaths.
Evidence-Based Interventions to Prevent and Treat Diarrheal Disease
The current treatment package for diarrhea was recommended in a 2004 WHO and UNICEF joint statement and consists of a combination of both low-osmolarity oral rehydration salts (ORS) and zinc. Adding zinc treatment has been shown to reduce the duration and frequency of each illness episode. The combined ORS/zinc treatment should be combined with continued feeding of the child, including increased fluid intake and breastfeeding. Important preventive interventions include: increasing coverage of the rotavirus and measles vaccines; promoting exclusive breastfeeding for the first six months of life and vitamin A supplementation; as well as water, sanitation and hygiene interventions including handwashing with soap.
Key Diarrheal Disease Prevention Activities
MCHIP advocates globally for increased visibility of diarrheal disease as a prominent, yet often forgotten, killer of children, and for the integration of diarrheal disease programs with other child health programs (including pneumonia, malaria, nutrition and newborn health initiatives). In 2013, MCHIP provided technical assistance in the development of the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD), which details a roadmap of interventions that protect, prevent and treat these childhood illnesses. MCHIP continues to participate in the Diarrhea and Pneumonia Working Group, which supports treatment scale-up in 10 high-burden countries.
At the country level, MCHIP works to make zinc accessible to all by ensuring its classification as an over-the-counter medicine. In health facilities, MCHIP works to ensure that oral rehydration therapy (ORT) corners are functioning with both supplies and trained health staff. MCHIP contributes to creating and revising health worker job aids and treatment guidelines that include evidence-based, high-impact interventions such as ORS/zinc,continued feeding and breastfeeding, and key water, sanitation, and hygiene (WASH) interventions (including handwashing with soap). To bring lifesaving case management of diarrhea to the unreached, MCHIP supports the introduction and expansion of integrated Community Case Management (iCCM). (For more information about MCHIP’s accomplishments in preventing diarrhea through introduction and expansion of rotavirus and measles vaccines, click here.)
The increased attention on child health in general, and on diarrheal disease in particular, reflects the substantial investments that MCHIP has made in global advocacy. The GAPPD report will help national governments and their partners in scaling up prevention and treatment interventions that will help end preventable child deaths. MCHIP has reached the previously unreached by supporting the introduction and expansion of iCCM at both global and national levels.
1 UNICEF Countdown 2012 report