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Related Experiment Videos

Effectiveness of ARI control strategy on underfive mortality.

V P Reddaiah1, S K Kapoor

  • 1Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi.

Indian Journal of Pediatrics
|January 1, 1991
PubMed
Summary

Implementing acute respiratory infection (ARI) control strategies, including measles immunization, significantly reduced child mortality in Haryana. The intervention demonstrated substantial benefits, particularly from measles vaccination, for child survival.

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Area of Science:

  • Public Health
  • Epidemiology
  • Pediatrics

Background:

  • Acute respiratory infections (ARI) pose a significant threat to child mortality globally.
  • Existing health infrastructure in rural Haryana faced challenges in managing ARI effectively.
  • Previous mortality rates for under-fives were higher in the study area compared to the control area.

Purpose of the Study:

  • To evaluate the impact of WHO-advocated ARI control strategies on child mortality in a rural Indian setting.
  • To assess the effectiveness of enhanced immunization programs, specifically for measles and DPT, in reducing ARI-related deaths.
  • To compare the outcomes of standard ARI case management with the benefits of measles immunization.

Main Methods:

  • A prospective intervention study was conducted in Ballabgarh block, Haryana, comparing an intervention area with a control area.

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  • ARI control strategies aligned with WHO recommendations were implemented in the intervention area.
  • Measles and DPT immunization coverage was intensified, and ARI cases were managed using standard procedures.

    • Main Results:

    • Initial under-five, infant, and 1-4 year mortality rates were statistically higher in the intervention area.
    • After two years, substantial reductions in mortality were observed in the intervention area, with statistically non-significant differences compared to the control area.
    • A 37% reduction in under-five mortality and a 26% reduction in ARI mortality were achieved, with measles immunization showing greater benefit than standard case management.

    Conclusions:

    • ARI control programs, especially when incorporating robust measles immunization, are effective in reducing child mortality in rural settings.
    • Integrating village-based private practitioners into ARI control strategies can enhance case management effectiveness.
    • The findings advocate for the vigorous national-level implementation of comprehensive ARI control programs, prioritizing measles vaccination.