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Acute respiratory infections in children under five years. Control project in Bagamoyo District, Tanzania
Insights
Community health workers significantly reduced child mortality from acute respiratory infections (ARI) in Tanzania. Home visits and on-the-spot treatment lowered under-five deaths by 27.2%, demonstrating effective primary healthcare outreach.
Area of Science:
- Public Health
- Pediatrics
- Global Health
Background:
- Acute respiratory infections (ARI) are a leading cause of mortality in children under five.
- Primary Health Care (PHC) integration is crucial for managing childhood illnesses in resource-limited settings.
Purpose of the Study:
- To evaluate the impact of a community-based ARI control program on under-five mortality in rural Tanzania.
- To assess the effectiveness of Village Health Workers (VHWs) in delivering ARI prevention and treatment services.
Main Methods:
- Implementation of an integrated PHC program involving VHW home visits every 6-8 weeks.
- Health education on ARI recognition and prevention.
- On-the-spot treatment of pneumonia with oral Cotrimoxazole by VHWs or referral.
Main Results:
- A 27.2% reduction in total under-five mortality (from 40.1 to 29.2/1000).
- A 30.1% reduction in pneumonia-specific mortality (from 14.3 to 10.0/1000).
- Pneumonia reduction contributed 40% to the overall mortality decrease.
Conclusions:
- Active health service outreach within PHC effectively reduces child mortality from ARI.
- Community-based interventions by VHWs are a viable strategy for improving child survival.
- The model shows potential for addressing other child health issues like diarrheal diseases and malnutrition.
Abstract:
Control of acute respiratory infections (ARI) in children under five years of age has been implemented as an integrated part of Primary Health Care in rural Bagamoyo District in Tanzania. Community supported Village Health Workers visited each family at their homes every six to eight weeks, giving health education on recognition and prevention of ARI, treating children with pneumonia on the spot with oral Cotrimoxazole or referring them to the next higher level of care. Within a two-year period the total under five mortality has been reduced by 27.2% from 40.1 to 29.2/1000 children aged under five per year. The disease-specific mortality rate for pneumonia has been reduced by 30.1% from 14.3 to 10.0/1000 under-five per year, contributing 40% to the overall mortality reduction. It is concluded that an active health service outreach programme, within Primary Health Care, can efficiently reduce high child mortality rates from ARI and other diseases. A similar approach will be used to tackle other problems such as diarrhoeal diseases, malnutrition, malaria and child spacing.