Bangladesh: a success case in combating childhood diarrhoea
| العنوان: | Bangladesh: a success case in combating childhood diarrhoea |
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| المؤلفون: | Sukumar Sarker, Mohd Anisul Karim, Neff Walker, Abdullah Nurus Salam Khan, Sk Masum Billah, Farhana Karim, Robert E. Black, M. Altaf Hossain, Aniqa Hassan, Bianca D Jackson, Shams El Arifeen, Mohammad Masudur Rahman, Afrin Iqbal, Shahreen Raihana, Nazia Binte Ali |
| المصدر: | Journal of Global Health |
| بيانات النشر: | International Global Health Society, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Diarrhea, Program evaluation, medicine.medical_treatment, 030231 tropical medicine, Psychological intervention, Breastfeeding, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Infant Mortality, medicine, Humans, Research Theme 4: Control of Childhood Diarrhea Mortality, 030212 general & internal medicine, Oral rehydration therapy, Bangladesh, Government, business.industry, Health Policy, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, Achievement, Private sector, Child, Preschool, Child Mortality, Latrine, business, Breast feeding, Program Evaluation |
| الوصف: | Background Bangladesh had a large reduction in childhood deaths due to diarrhoeal disease in recent decades. This paper explores the preventive, promotive, curative and contextual drivers that helped Bangladesh achieve this exemplary success. Methods Primary and secondary data collection approaches were used to document trends in reduction of Diarrhoea Specific Mortality Rate (DSMR) between 1980 and 2015, understand what policies and programmes played key roles, and estimate the contribution of specific interventions that were implemented during the period. Data acquisition involved relevant document reviews and in-depth interviews with key stake-holders. A systematic search of literature was undertaken to explore socio-economic, aetiological, behavioural, and nutritional drivers of diarrhoeal disease reduction in Bangladesh. Finally, we used LiST (Lives Saved Tool) to model the contributions of the relevant interventions during three time periods (1980-2015, 1980-2000 and 2000-2015), and to project the number of lives saved in 2030 (compared to 2015) if these interventions were implemented at near universal coverage (90%). Results The factors which likely had the most impact on DSMR were the coordinated efforts of the Government of Bangladesh (GoB) with non-government organizations (NGOs) and the private sector that enabled swift implementation, at scale, of interventions like oral rehydration solution (ORS) and zinc, promotion of breastfeeding, handwashing and sanitary latrines (WASH), as well as improvements in female education and nutrition. Compared to 1980, we found ORS and reduction in stunting prevalence had the greatest impact on DSMR, saving roughly 70 000 lives combined in 2015. Until 2000, ORS had a higher contribution to DSMR reduction than reduction in stunting prevalence. This proportionate contribution was reversed during 2000-2015. At near universal coverage (90%) of combined direct diarrhoeal disease, nutrition and WASH interventions, we project that an additional 5356 deaths due to diarrhoea could be averted in 2030. Conclusion Bangladesh's achievement in reduction of DSMR highlights the important role of an enabling policy environment that fostered coordinated efforts of the public and private sectors and NGOs for maximal impact. To maintain this momentum, evidence-based interventions should be scaled up at universal coverage. |
| تدمد: | 2047-2986 2047-2978 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e931b5181ad2dd233649c538e83ef1c2Test https://doi.org/10.7189/jogh.09.020803Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e931b5181ad2dd233649c538e83ef1c2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20472986 20472978 |
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