Diarrhea in developing countries

The World Health Organization reports diarrhea kills around 760,000 children under five every year. This is the second most common cause of child deaths worldwide.

Over half of these fatalities happen in India, Nigeria, Pakistan and Ethiopia.

Malnutrition is an underlying factor in one third of preventable child deaths and plays a significant role in fatal diarrhea episodes.

In children with persistent or chronic diarrhea, malnutrition and weakened immune systems threaten their long-term physical and cognitive development.

Bacterial, viral, or parasitic infection

Diarrhea is usually a symptom of bacterial, viral, or parasitic infection that results from eating contaminated food or drinking polluted water or from person-to-person contact.

It is more prevalent in the developing world because of:

a lack of safe drinking water and basic sanitation facilities
poor hygiene practices
higher prevalence of malnutrition
overall lower health status

More than 2.5 billion people are without sustainable access to basic sanitation.

Some one billion people excrete in open places, an important factor in the transmission of diarrheal diseases.

About 748 million people still rely on drinking-water sources considered unsafe.

Prevention and treatment

To treat diarrhea, UNICEF and the World Health Organization recommend oral rehydration salts and zinc.

This regimen works to improve immune response in zinc-deficient children, particularly for subsequent episodes of diarrhea. The treatment costs approximately C$1 per dose and can save the life of a child.

The majority of children living in vulnerable conditions in developing countries still do not have access to this important intervention.

That is why Canada is working with key partners to ensure treatment is scaled up in the countries with the greatest need.

Growing focus on preventative measures

Although the treatment of diarrhea is critical, there is a growing focus on preventative measures, including:

breastfeeding and vitamin A supplementation
rotavirus and measles vaccination
hand washing with soap
improved drinking water supply
basic sanitation

Canada supports many international development activities that aim to prevent and treat diarrhea, and decrease child mortality.

One million cases treated

The World Health Organization’s Rapid Access Expansion Program aims to assist in reducing child mortality through community-delivered diagnostic and treatment services for malaria, pneumonia and diarrhea.

It is focused on the Democratic Republic of the Congo, Malawi, Mozambique, Niger and Nigeria.

Since the start of the program in April 2013 around one million diarrhea cases have been treated.

Targeted strategies to combat disease are used in each country. Health workers were provided with bicycles or motorcycles to help them travel to villages. Accommodation was built in areas where health workers were needed.

Combatting disease with zinc and Vitamin A

Nutrition International is a global leading organization working exclusively to eliminate vitamin and mineral deficiencies in the most vulnerable populations.

Nutrition International distributes zinc supplements and vitamin A in developing countries. In 2014 alone, MI's programming ensured that more than 150 million children under the age of five received vitamin A supplementation two times per year.

Nutrition International is also collaborating with Canadian metals and mining company Teck Resources and the Government of Canada on the Zinc Alliance for Child Health (ZACH). This work seeks to scale up zinc and oral rehydration solutions treatment for diarrheal disease in Senegal, Burkina Faso and Ethiopia.

More than eight million children under the age of five presenting with diarrhea were treated with zinc and rehydration solutions. More than 29,000 health care providers received training or orientation on the benefits of treating childhood diarrhea with zinc and rehydration solutions.

Increasing access to rotavirus vaccines

Gavi, the Vaccine Alliance works to prevent diarrhea by increasing access to rotavirus vaccines.

It is estimated that more than 2.4 million child deaths can be prevented by 2030 through the accelerated introduction of rotavirus vaccines to Gavi-eligible countries.

Canada provided Gavi with additional support to improve access to rotavirus and pneumococcal vaccines in Gavi-eligible countries of La Francophonie in Central and West Africa.

It is estimated that these efforts will provide 890,000 children with rotavirus vaccines against diarrhea.

Ghana’s Northern Region Small Towns project

The Northern Region Small Towns (NORST) project will provide 125,000 people living in small towns in northern Ghana with access to safe drinking water. Only 14% of the population had access to enhanced sanitation services.

The project is being carried out in conjunction with the Canadian non-governmental organization Right to Play. It also teaches children and young people safety and health practices. Results achieved to date include:

74,265 people in five districts of northern Ghana have access to safe drinking water
275 households have invested in household latrines, with 3,575 people currently benefiting from improved latrines in their households
8,700 people are now using improved latrines through the provision of 23 institutional latrines
19,890 children are currently practising regular handwashing with soap as a result of the “healthy play” activities introduced by the project

Water Sanitation and Hygiene project

UNICEF aims to enhance sanitation services in schools and communities in the five most deprived regions of Ghana. The Water, Sanitation and Hygiene (WASH) project results achieved to date include:

198,500 people from 397 communities live in open-defecation-free communities
35,042 people now have improved sanitation facilities in their households
47,163 children from 150 schools have access to safe and clean drinking water
4,125 children have access to improved sanitation facilities
56,361 children have been reached with sanitation and hygiene behaviour-change messages
4,500 children from 150 school health clubs have become agents of change for sanitation and hygiene behaviour in their schools and surrounding communities

Community-Led Health Bangladesh project

The HOPE International Development Agency aims to improve maternal, newborn, child and adolescent health in three assemblies in southern and central Bangladesh.

Through the Community-Led Health Bangladesh project greater knowledge is helping to increase the adoption rate for the usage and construction of improved latrines.

For instance, as of March 2014, 67 sets of demonstration latrines and 279 sets of latrine materials were provided to project beneficiaries.

An additional 333 families constructed latrines with their own contribution of local materials.

Encouraging people to use toilets

Hygiene practices have improved significantly since the beginning of project activities. 72% of the target population adopting basic hygiene practices versus a baseline of 10%. Also latrine usage increased to 30 percent versus a baseline of seven percent.

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