Subject(s)
Health Services Administration , Human Development , Bangladesh , Developing Countries , Humans , Poverty , Quality of LifeABSTRACT
PIP: In Bangladesh, the executive director of the Bangladesh Rural Advancement Committee (BRAC) gave an acceptance speech at an awards ceremony celebrating the key role of the International Centre for Diarrhoeal Research, Bangladesh (ICDDR,B) in the discovery of oral rehydration solution [ORS]. For more than 10 years, BRAC has been involved in distributing information about ORS to rural and urban mothers in Bangladesh. BRAC learned more about rural Bangladesh when it began its ORS program. Thousands of BRAC workers disseminated the message about ORS to almost 13 million homes. The most important fact they learned was that the mother is the key health provider in the family. So BRAC focused on mothers. BRAC workers communicated directly with mothers while conveying a message of hope for their children. BRAC motivated its workers with incentives when mothers could properly prepare ORS and remember key points in preventing and treating diarrhea. BRAC's ORS program was first a pilot project. It successfully spread nationwide and showed that nongovernmental organizations could expand without losing quality. Cooperation with the government, sound management principles, and a devoted staff motivated to think on a grand scale contributed to BRAC's national ORS program. ORS-oriented organizations and individuals must continue conducting ORS-related research to continue and build on its success. For example, BRAC based its program on ICDDR,B research in the development of oral rehydration therapy and implementation of diarrhea treatment programs. BRAC intends to continue fighting diarrhea until it is no longer a major threat to Bangladesh's children.^ieng
Subject(s)
Achievement , Community Health Workers , Diarrhea , Fluid Therapy , Information Services , Organizations , Asia , Bangladesh , Behavior , Delivery of Health Care , Developing Countries , Disease , Health , Health Personnel , Health Planning , TherapeuticsABSTRACT
Sugar-based oral rehydration therapy (ORT) for diarrhoea is promoted in many countries of the world. One programme in Bangladesh has instructed more than 13 million mothers in the preparation of a sugar-salt solution in the home; despite very high rates of correct mixing and knowledge, subsequent application was found in only some 20% of all diarrhoea episodes. Since rice is far more available in rural homes (95%) than any type of sugar (30%) and rice gruel is a widely accepted food during illness, a field trial was conducted in three areas (total population, 68,345) to compare the acceptability and use of rice-based ORT with that of sugar-based ORT. Although the mothers unanimously agreed that the rice-based solutions "stopped" the diarrhoea more quickly, they used the sugar-based solutions twice as often (in 40% of severe watery episodes) as the rice-based solutions (in 18%), because the rice-ORT was much more time-consuming and difficult to prepare. The observed reduced utilization of home-made rice-ORT makes it a poor substitute for sugar-ORT at the community level in rural Bangladesh.
PIP: Sugar-based oral rehydration therapy (ORT) for diarrhea is promoted in many countries in the world. 1 program in Bangladesh has instructed more than 13 million mothers in the preparation of a sugar-salt solution in the home; despite very high rates of correct mixing and knowledge, subsequent application was found in only some 20% of all diarrhea episodes. Since rice is far more available in rural homes (95%) than any type of sugar (30%) and rice gruel is a widely accepted food during illness, a field trial was conducted in 3 areas (total population=68,345) to compare the acceptability and use of rice-based ORT with that of sugar-based ORT. Although the mothers unanimously agreed that the rice-based solutions stopped the diarrhea more quickly, they used the sugar-based solutions twice as often (in 40% of severe watery episodes) as the rice-based solutions (in 18%), because the rice ORT was more time-consuming and difficult to prepare. The observed reduced utilization of homemade rice-ORT makes it a poor substitute for sugar-ORT at the community level in rural Bangladesh. (author's)
Subject(s)
Diarrhea/therapy , Fluid Therapy/methods , Oryza , Patient Acceptance of Health Care , Adolescent , Adult , Aged , Bangladesh/epidemiology , Child , Child, Preschool , Cultural Characteristics , Diarrhea/epidemiology , Fluid Therapy/standards , Fluid Therapy/statistics & numerical data , Humans , Incidence , Mothers/education , Retrospective StudiesABSTRACT
Home-made oral rehydration solutions (ORS) have been promoted in developing countries for preventing dehydration due to diarrhoea. Evaluations of this method must take into account the effective usage rates achieved and the safety of the solutions used. A community programme organized by the Bangladesh Rural Advancement Committee (BRAC) has visited over a third of all the households in Bangladesh and taught the preparation and use of an oral rehydration solution made from lobon (common salt) and gur (unrefined sugar)--abbreviated to LGS. An evaluation study based on over 7000 households enabled different usage rates to be calculated for four different diarrhoea types. The overall usage of LGS for all diarrhoea episodes was around 5-10% but for what the people called 'Severe Diarrhoeas' or cholera it was found to be between 25% and 52%. The mother's ability to prepare a safe Lobon-gur solution appeared to deteriorate about six months after training and it was significantly poorer in the Second Phase than the First Phase of the BRAC programme.
Subject(s)
Diarrhea, Infantile/therapy , Diarrhea/therapy , Fluid Therapy , Home Nursing , Adolescent , Adult , Bangladesh , Child , Child, Preschool , Diarrhea/epidemiology , Diarrhea, Infantile/epidemiology , Female , Fluid Therapy/adverse effects , Humans , Infant , Infant, Newborn , Male , Middle Aged , Rural PopulationABSTRACT
PIP: Mothers in over 5 million Bangladeshi households were taught how to prepare and use an oral rehydration solution containing lobon (local salt) and gur (unrefined sugar). An evaluation of the results has demonstrated the value of the program and has shown how improvements can be made in the teaching process as well as in the preparation and administration of the solution. Initial findings noted a reduction in the ability of mothers to prepare a safe and effective lobon-gur solution. This was disturbing and clearly needed careful attention from program organizers. Increased emphasis is now being placed on the danger of too much salt and on the importance of correctly measuring the ingredients. Because gur is not widely available at all times of the year, refined sugar is being promoted as an alternative. This evaluation made it possible to adopt new policies and replan health activities. In place of individual training, the joint instruction of mothers from neighboring households has been adopted in the belief that group reinforcement and acceptance will encourage increased usage.^ieng
Subject(s)
Diarrhea, Infantile/therapy , Fluid Therapy , Mothers , Self Care/methods , Bangladesh , Child , Child, Preschool , Female , Fluid Therapy/adverse effects , Fluid Therapy/economics , Fluid Therapy/statistics & numerical data , Humans , Infant , Infant, Newborn , Plant Extracts , Saccharum , SolutionsABSTRACT
Mothers in over 5 million Bangladeshi households were taught how to prepare and use an oral rehydration solution containing lobon (local salt) and gur (unrefined sugar). An evaluation to the results has demonstrated the value of the programme and has shown how improvements can be made in the teaching process as well as in the preparation and administration of the solution. Increased emphasis is now being placed on the danger of too much salt and on the importance of correctly measuring the ingredients. Because gur is not widely available at all times of the year, refined sugar is being promoted as an alternative
