Preventing diarrhoea should be global priority, says WHOBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3372 (Published 18 August 2009) Cite this as: BMJ 2009;339:b3372
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I read your article published 18/Aug/2009; doi: 101136/bmj.b3372. I do join this Global forum to make prevention of diarrhea a global priority as per statement release by the WHO.
In Uganda, diarrhea is still the second childhood killer disease among children under five just after malaria. The early introduction of integrated management of childhood illnesses (IMCI) program paved a way of managing diarrhea among other childhood illnesses but as the author clearly states; the previous interventions need to be re-examined for effectiveness and efficiency if the primary goal is that of reducing costs by decreasing un necessary use of antibiotics which not only are expensive but also are increase risks of resistance.
Using Zinc in combination with Oral rehydration salts in an effort to reduce use of intravenous fluids needs to embraced by health workers in a struggle to achieve the millennium goal of reducing child mortality rates.
The challenges foreseen in developing countries Uganda inclusive remains at looking at costs of making Zinc available and accessible at even lower level health units both government and private health units. We should also be cognizant about the fact that the majority of low income population stays in villages or country side.
Buy-in on the part of Governments for such program is extremely important if programs like this one are to succeed. Financing health programs remains paramount and therefore budget allocation for such programs is vital. Health worker training in terms of continued profession development to emphasize advantages of Zinc in combination with oral rehydration salts needs to be widely spread especially when we know that intravenous fluids needs skilled health worker to be introduced. It is therefore imperative to support this global notion.
College of Health Science, Makerere University
Competing interests: No competing interests