Dataset Information

Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy.

ABSTRACT:

Background

Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes.

Methods

We used a Bayesian geostatistical model and data from household surveys to map the percentage of children with diarrhea that received (1) any ORS, (2) only RHF, or (3) no oral rehydration treatment between 2000 and 2018. This approach allowed examination of whether RHF was replaced with ORS before and after interventions, policies, and external events that may have impacted healthcare access.

Results

We found that RHF was replaced with ORS in most Sierra Leone districts, except those most impacted by the Ebola outbreak. In addition, RHF was replaced in northern but not in southern Mali, and RHF was not replaced anywhere in Senegal. In Senegal, there was no statistical evidence that a national policy promoting ORS use was associated with increases in coverage. In Sierra Leone, ORS coverage increased following a national policy change that abolished health costs for children.

Conclusions

Children in parts of Mali and Senegal have been left behind during ORS scale-up. Improved messaging on effective diarrhea treatment and/or increased ORS access such as through reducing treatment costs may be needed to prevent child deaths in these areas.

SUBMITTER: Wiens KE

PROVIDER: S-EPMC7750121 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy.

Wiens Kirsten E KE Schaeffer Lauren E LE Sow Samba O SO Ndoye Babacar B Cain Carrie Jo CJ Baumann Mathew M MM Johnson Kimberly B KB Lindstedt Paulina A PA Blacker Brigette F BF Bhutta Zulfiqar A ZA Cormier Natalie M NM Daoud Farah F Earl Lucas L Farag Tamer T Khalil Ibrahim A IA Kinyoki Damaris K DK Larson Heidi J HJ LeGrand Kate E KE Cook Aubrey J AJ Malta Deborah C DC Månsson Johan C JC Mayala Benjamin K BK Mokdad Ali H AH Ogbuanu Ikechukwu U IU Sankoh Osman O Sartorius Benn B Topor-Madry Roman R Troeger Christopher E CE Welgan Catherine A CA Werdecker Andrea A Hay Simon I SI Reiner Robert C RC

BMC medicine 20201221 1

<h4>Background</h4>Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RH ...[more]

PMID: 33342436

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Dataset Information

Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy.

Background

Methods

Results

Conclusions

Publications

Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy.

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