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Child survival in a rural area in Zimbabwe: are we winning?
1Chimanimani Hospital, Zimbabwe.
Insights
Child survival programs in rural Zimbabwe reduced child mortality by improving immunisation coverage and diarrhoea management. Despite challenges, dedicated efforts show significant progress in child health outcomes.
Area of Science:
- Public Health
- Pediatrics
- Global Health
Background:
- Child survival programs have been ongoing in a rural Zimbabwean district since 1984.
- Under-five morbidity and mortality remain significant public health concerns in developing regions.
Purpose of the Study:
- To prospectively investigate the causes of morbidity and mortality in children under five years old.
- To assess the impact of child survival programs on nutrition, immunisation, and diarrhoea management.
Main Methods:
- Community-based surveys were conducted to evaluate nutrition status.
- Immunisation coverage rates were assessed in 12-23-month-old children.
- Knowledge and utilization of oral rehydration solutions for diarrhoea were evaluated.
Main Results:
- Malnutrition, acute respiratory infections, and diarrhoea were the primary causes of under-five admissions (69.7%) and deaths (67.4%).
- Full immunisation coverage increased from 44.3% in 1984 to 70% in 1989.
- 69% of mothers correctly prepared and used sugar-salt solutions for diarrhoea management.
Conclusions:
- Child survival programs can achieve significant results in remote rural districts with political will and community involvement.
- While direct impact on malnutrition and infections was limited, improvements in immunisation and diarrhoea management were notable.
- Sustaining progress and implementing socio-economic reforms present ongoing challenges for health teams and policymakers.
Abstract:
Health teams in a rural district in Zimbabwe have been implementing child survival programmes since 1984. A prospective study of the causes of morbidity and mortality in under-five children was done. Community based surveys assessing nutrition status, immunisation coverage and knowledge and use of sugar and salt solution for diarrhoea were carried out. Malnutrition, acute respiratory infections and diarrhoea accounted for 69.7 pc of the 902 under-fives admissions while 33 (67.4 pc) of the hospital deaths were under-fives. The mortality pattern parallelled that of morbidity. Malnutrition was more common in the dry communal areas and on the commercial estates. Full immunisation coverage rates in the 12-23-month-olds increased from 44.3 pc in 1984 to 70 pc in 1989; and up to 69 pc of the mothers correctly prepared and used sugar and salt solution for diarrhoea management. Although there appears to have been little impact on malnutrition, respiratory infections and diarrhoea, the study shows that a lot can be achieved even in a remote rural district given political will, community involvement, and dedicated staff. The maintenance of the current momentum and the introduction of further socio-economic reforms is a big challenge facing the health teams, community members and politicians.