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A Half Century of Oral Rehydration Therapy in Childhood Gastroenteritis: Toward Increasing Uptake and Improving Coverage

  • Amira M. Khan
  • James E. Wright
  • Zulfiqar A. BhuttaEmail author
PARADIGM SHIFTS IN PERSPECTIVE

Abstract

Termed by the Lancet, as “potentially the most important medical advance of the twentieth century,” therapy with oral rehydration solutions (ORSs) has been essential to reducing mortality in children less than 5 years (under five) with infectious gastroenteritis and diarrhea. The target of the diarrhea-control programs in the 1990s was to achieve ORS use in 80% of diarrhea cases by the year 2000. Nevertheless, nearly 20 years later, global uptake remains limited to only a third of the cases. Our analysis shows that from 1990 to 2017, mean ORS coverage in Countdown countries [the 81 Countdown-to-2030 priority countries, which together account for 95% of maternal deaths and 90% of under-five deaths] increased from ~ 30% to nearly 40%. Flawed government policies, inadequate supplies, and lack of awareness among health workers and communities all contributed to this shortfall in coverage. Moreover, imperfect measurement methodology is implicated in questionable coverage data. A multipronged approach focusing on the manufacture, supply, training, and behavioral change is essential to ensure that ORS is used in all epidemic diarrhea cases globally, especially in the under-five population.

Keywords

Oral rehydration solution ORS ORT Diarrhea Coverage Rehydration Child health 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Amira M. Khan
    • 1
  • James E. Wright
    • 1
  • Zulfiqar A. Bhutta
    • 1
    • 2
    Email author
  1. 1.Centre for Global Child HealthThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Center of Excellence in Women and Child HealthThe Aga Khan UniversityKarachiPakistan

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