Why Rural Children Die Of Diarrhoea And Pneumonia?

The reason why a large number of children under the age of five years die of diarrhoea and pneumonia, generally in rural India and especially in Bihar, has become clear.

Diarrhoea and pneumonia are the biggest killer diseases in children in India. With 55 per 1,000 live births, Bihar has the highest infant mortality rate in the country. But 340 health care providers in rural Bihar rarely practice what little they know about treating children suffering from these two diseases.

“Vignette” interviews with the providers were conducted to assess their knowledge of diagnosing and treating children with these diseases. Later, the actual treatment offered by the health care providers was assessed by sending “patients” pretending to suffer from the same symptoms as in the interviews.

If the providers’ exhibited “low levels” of knowledge about the two diseases during the interviews, it was even worse in practice. Though during the interview 72 per cent of them correctly reported they would prescribe the cheap, life-saving oral rehydration salts (ORS) to children suffering from diarrhoea, in practice, none prescribed the correct treatment — only ORS.

In practice, almost 72 per cent did not give ORS. Instead, they prescribed harmful drugs or antibiotics. The 17 per cent providers who did prescribe ORS also added antibiotics to the regimen, which is unnecessary, says a Duke University release. Antibiotics were prescribed despite the “patients” not asking for them.

Eighty per cent of providers in the study did not have a medical degree. While those with medical training did have large gaps between what they knew and what they practiced, they were “significantly less likely” to prescribe harmful drugs.