Development Issues: Health and Nutrition, Children, Youth, Diarrhoea, Women

Programme Summary

Results from a series of studies indicated that, despite a vigorous Oral Rehydration Therapy (ORT) Programme in India for more than a decade, knowledge and use of ORT to treat childhood diarrhoea remain quite limited. Very small percentages of children who fall sick with diarrhoea are treated with oral rehydration salt (ORS) packets, recommended home solution (RHS), or increased fluids, despite the fact that 61 percent of these children receive treatment from a health facility or provider. In the NFHS, among children born 1-47 months before the survey who had diarrhoea in the last two weeks, 18 percent were given ORS and 19 percent were given RHS. Considered together, only 31 percent were given ORS or RHS.

Among those who receive treatment from a health facility or provider, a very large proportion (94 percent) are treated with antibiotics or other anti-diarrhoeal drugs, contrary to WHO recommendations that drugs not be used to treat diarrhoea in young children. The use of drugs is common among both public- and private-sector providers but is more common in the private sector.

This project is one of many sponsored by India's Ministry of Health and Family Welfare which provides national and state-level estimates of fertility, infant and child mortality, family planning practice, maternal and child health, and the utilization of services available to mothers and children. Community-level mass media and rural group education were stressed in this multi-media programme promoting ORT and RHS.

Summary of ICT Initiatives

Radio, television, exhibitions, drama, song performance, and cinema were all used to promote the use of ORT and RHS. Spot messages on electronic media educating mothers and communities about home management of diarrhoea were broadcast regularly.

Observations

The analysis indicated that mother's exposure to electronic mass media increases awareness and use of oral rehydration therapy. Women regularly exposed to radio, television, or cinema are much more likely than unexposed women to know about ORS packets and to use ORS, RHS or increased fluids to treat childhood diarrhoea. Both mothers and health-care providers are not well informed about the proper treatment of childhood diarrhoea. In rural areas, community-level mass media and group educational activities have positive effects on knowledge and use of ORT, independent on exposure to mass media and other socio-economic and demographic variables. Discrimination was seen against girls in the use of ORT.

The following data was extracted from the most recent evaluation in November 1998:

Access: 39% of women access radio at least once a week, 27% watch television once a week and 14% go to the cinema hall or theatre at least once a month. 48% are regularly exposed to at least one of the electronic mass media. 52% are not exposed regularly.

Knowledge Shifts: Only 43% of women giving birth four years before the survey knew about ORS packages, ranging from 20% knowledge to greater than 70%. 56% of exposed women knew about ORS compared to only 32% of exposed women.

Practices: About 25% of women had ever used an ORS. Among children receiving treatment for diarrhoea, public health facilities or providers were more likely to recommend ORS or RHS (45% of the time) than those from private-sector (37% of the time). 20% of children were treated with ORS by exposed mothers as opposed to only 15% among unexposed women. 22% of children were treated with RHS by exposed mothers compared to only 16% of unexposed mothers.

Partners: Ministry of Health and Family Welfare, International Institute for Population Sciences, East-West Centre Program on Population, Macro International, 18 Population research Centres, United States Agency for International Development (USAID)

Source: K. V. Rao, Vinod K. Mishra, and Robert D. Retherford. Knowledge and Use of Oral Rehydration Therapy for Childhood Diarrhoea in India: Effects of Exposure to Mass Media. National Family Health Survey Subject Reports, Number 10, November 1998.

Also see the International Institute for Population Sciences website, and the National Family Health Survey website.

For More Information Contact:

International Institute for Population Sciences

Govandi Station Road, Deonar

Mumbai - 400 088, India

Fax: 91-22-556-3257

iips.nfhs@axcess.net.in

Click here to go back to the table of contents, or navigate above by clicking on "next page".