Under 5 Diarrhoeal Control

“In Zambia, diarrhoea is the 3rd leading cause of clinic visits and death for children under-5 years of age, after malaria and pneumonia…”

The Programme for Awareness and Elimination of Diarrhoeal Disease (PAEDD) is a new partnership between CIDRZ and Absolute Return for Kids (ARK), a U.K. based children’s charity, working with the Ministry of Health (MoH) to combat child diarrhoeal disease.  In Zambia, diarrhoea is the 3rd leading cause of clinic visits and death for children under-5 years of age, after  pneumonia and malaria.  Every year, at least 15,000 of Zambia’s 2.4 million children under-5 will die due to diarrhoea, and about a quarter to a third of these deaths are attributed to rotavirus, which is vaccine preventable.

Starting in Lusaka Province, PAEDD will support the MoH to reduce child death and disease due to diarrhoea through: (1) rotavirus vaccination; (2) improving clinical care and management of child diarrhoea and dehydration; and (3) advocacy and stimulating community action for prevention and treatment of child diarrhoea through targeted public health messaging.

PAEDD will target three critical areas of diarrhoea prevention and treatment:

  • Initiating a rotavirus vaccination programme

Work closely with MoH and other partners (including the United Nations Children’s Fund (UNICEF) and the World Health Organisation (WHO)) to support the strengthening and scale-up of the cold chain to prepare for the introduction of the rotavirus vaccine, as well as other new and under-utilised vaccines, not only in Lusaka Province, but country-wide.  This will include cold rooms, refrigerators, cold boxes and other equipment, as well as training cold chain technicians within MoH, and conducting an Effective Vaccine Management nation-wide training and assessment, a tool developed by the WHO to help countries monitor and improve vaccine management structures and procedures.  Vaccines will be integrated into the MOH routine Expanded Programme on Immunisations (EPI), will utilise WHO technical support and be procured through existing channels via UNICEF.

  • Improving clinical management of paediatric diarrhoea, including paediatric dehydration, low-osmolarity ORS, zinc, and intravenous fluids

Front-line health care providers at Maternal Child Health (MCH), outpatient, and inpatient facilities will be trained in improved diarrhoea case management that includes didactic lessons, practical hands-on skills build-up and mentoring, as well as use of low osmolality ORS and zinc.  A programme for quality assurance and quality control (QA/QC) will be part of the programme with a comprehensive monitoring and evaluation component.

  • Targeted public health messaging and social mobilisation for prevention and treatment of diarrhoea

Community-based education through lay staff, community outreach workers and drama groups will sensitise the community on the importance of vaccination, hand washing, the use of ORS and zinc, exclusive breastfeeding up to 6 months and to educate families to bring children to clinic early during the course of diarrhoeal illness.

Both CIDRZ and ARK are committed to the principle of sustainability and the need for effective immunisation programmes to be taken up as standard government practice.  Thus all planning and implementation activities occur within the Child Health Unit (CHU) of the MoH, and other local child health partners are fully involved.  The programme will operate at both international and national levels to ensure sustainability and to facilitate the sharing of findings with other governments and stakeholders, to inform their prevention and treatment policies.
With the guidance of the Ministry of Health, the leadership and experience of CIDRZ and global advocacy and financial support provided by ARK, we can together, save thousands of lives each year.