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Review on development and community implementation of oral rehydration therapy.
Sengupta, P G; Mondal, S K; Ghosh, S; Gupta, D N; Sikder, S N; Sircar, B K.
Afiliación
  • Sengupta PG; Division of Epidemiology, National Institute of Cholera and Enteric Diseases, Calcutta.
Indian J Public Health ; 38(2): 50-7, 1994.
Article en En | MEDLINE | ID: mdl-7835996
ABSTRACT
PIP: Dehydration is the major reason children die from diarrhea. The key element of the WHO Diarrhoeal Disease Control (CDD) Programme is implementation of oral rehydration therapy (ORT). ORT implementation includes production and distribution of packets of oral rehydration salts (ORS), training of medical and paramedical personnel and education of mothers, and operational/health services research for identification of suitable strategies for implementation. Most ORT-related research has been done in hospitals. Community health workers in India have been given ORS packets to use to treat diarrhea cases at home. Operational research in India shows that volunteer health guides can train mothers to give available and culturally acceptable home fluids to children with mild diarrhea before dehydration develops. Use of home available fluids greatly reduces the need for ORS packets. Another possible alternative to ORS was sugar salt solution (SSS) or household formula, but research shows that mothers tend to prepare SSS inaccurately. The success of the CDD program depends on ORS production and proper distribution. In India, more than 100 companies produce about 130 different commercial ORS products, indicating a need for quality control. The best indicators to evaluate India's CDD program are ORS access and ORT use rates. In India, the 1991 ORS and ORT use rates were only 7% and 14%, respectively. The approach to ORT in India is mothers should treat children with diarrhea with no dehydration, village level workers should manage dehydrated patients with ORS, and health professionals at the nearest health facility should treat severely dehydrated patients with either ORS or intravenous fluids. ORT has reduced child mortality in India from 1.9% to 0.6%. Major barriers to ORT implementation are scarcity of resources, lack of political commitment, managerial and organizational problems, and problems related to community participation, health personnel, and dissemination of information.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Soluciones para Rehidratación / Diarrea / Fluidoterapia / Programas Nacionales de Salud Tipo de estudio: Prognostic_studies Aspecto: Implementation_research Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Indian J Public Health Año: 1994 Tipo del documento: Article Pais de publicación: India
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Soluciones para Rehidratación / Diarrea / Fluidoterapia / Programas Nacionales de Salud Tipo de estudio: Prognostic_studies Aspecto: Implementation_research Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Indian J Public Health Año: 1994 Tipo del documento: Article Pais de publicación: India