Diarrhoea: Why children are still dying and what can be done A 2009 UNICEF/ WHO Report, presented by: Camille Saadé, AED/ POUZN Director Reconvening Bangkok: 2007 to 2010 – Progress Made and Lessons Learned in Scaling-Up FP-MNCH Best Practices in the AME Region 7 – 11 March 2010

2 Asia and Africa account for more than ¾ of childhood diarrhoea

3 Diarrhoea is the second most common cause of child deaths worldwide

More than 80% of child deaths due to diarrhoea occur in Africa and South Asia

5 India 386,600 Afghanistan 82,100 Pakistan 53,300 Bangladesh 50,800 China 40,000 Child deaths from diarrhoea in top five Asian countries

A 7 -point plan for comprehensive diarrhoea control Treatment package: 1 - ORT 2 - Zinc treatment Prevention package: 3 - Rotavirus (4/09) and measles vaccination 4 - Exclusive BF and vit. A supplementation 5 - Handwashing with soap 6 - Safe drinking water at POU 7 - Community-wide sanitation 6

7 Little or no progress in the use of ORS to treat diarrhoea

8 Countries with national guidelines including zinc treatment

9 UNICEF procurement of zinc

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New delivery strategies to improve uptake Possible solutions: Products need to be made more attractive to users (i.e. zinc and ORS taste) Products need to be packaged for more effective use (i.e. smaller ORS sachets) Products need to be delivered in innovative ways that maximize access (hygiene and sanitation promotion in schools, marketing of soap, latrines, POU) 11

It is possible! Political momentum to address leading causes of death: pneumonia and diarrhea 2008 = 30 th anniversary of Alma-Ata declaration -> focus on primary health care Essential to achieve MDG 4: reduce child mortality 12