Ronan Kelly
Retired 2020
In Rural India, Children Receive Wrong Treatments for Deadly Ailments
February 16, 2015
ARTICLE
DURHAM, NC - Few health care providers in rural India know the correct treatments for childhood diarrhea and pneumonia ? two leading killers of young children worldwide. But even when they do, they rarely prescribe them properly, according to a new Duke University study.
Medical practitioners typically fail to prescribe lifesaving treatments such as oral rehydration salts (ORS). Instead, they typically prescribe unnecessary antibiotics or other potentially harmful drugs, said Manoj Mohanan, a professor in Duke?s Sanford School of Public Policy, and lead author of the study.
Diarrhea and pneumonia accounted for 24 percent of deaths among children 1 to 4 years old, totaling approximately 2 million deaths worldwide in 2011. Bihar, India ? where the study was conducted ? has an infant mortality rate of 55 per 1000 live births, the highest in the country.
...
?We know from previous studies that providers in rural settings have little medical training and their knowledge of how to treat these two common and deadly ailments is low,? Mohanan said.
?Eighty percent in our study had no medical degree. But much of India?s rural population receives care from such untrained providers, and very few studies have been able to rigorously measure the gap between what providers know and what they do in practice.?
...
http://today.duke.edu/2015/02/wrongtreatment
The Know, Do, and Quality Gaps in International Maternal and Child Health Care Interventions
ONLINE FIRST
James M. Tielsch, PhD1
JAMA Pediatr. Published online February 16, 2015. doi:10.1001/jamapediatrics.2014.3741
Tremendous progress has been made in reducing the mortality rates for young children, especially in low- and middle-income countries, with annual deaths down from 12.6 million in 1990 to 6.3 million in 2013.1 Although it is unlikely that number 4 (reduce child mortality) of the Millennium Development Goals set by the United Nations in 20012 will be achieved by the deadline this year, an even more ambitious goal for the elimination of preventable deaths among newborns and children younger than 5 years by 2030 is likely to be set by the United Nations General Assembly in the fall of 2015.3 Discussions about these laudable goals often center on claims such as, ?we know what works, we just need to do it.? In fact, estimates of coverage of proven interventions for child survival are significantly lower than needed to maximize the effects, with the most important coverage gaps seen in the areas of family planning, interventions for newborns, and case management of childhood diseases, such as diarrhea, pneumonia, and malaria.4 This is often referred to as the know-do gap. In this issue, Mohanan et al5 provide a distressing description of this gap related to the diagnosis and treatment of diarrhea and pneumonia by health care practitioners in Bihar, India.
...
http://archpedi.jamanetwork.com/article.aspx?articleid=2118578
India: Poorly educated rural health providers wreaking havoc on child health
By Jayalakshmi K
February 17, 2015 05:08 GMT
...
Providers exhibited low levels of knowledge during the interviews and fared worse during the practice.
For example, for diarrhoea, while 72% said they would prescribe oral rehydration salts, only 17% actually did so. Those who did prescribe ORS added other unnecessary or harmful drugs.
In practice, none gave the correct treatment: only ORS, with or without zinc, and no other potentially harmful drugs.
Almost 72% of providers gave antibiotics or potentially harmful treatments without ORS.
...
http://www.ibtimes.co.uk/india-poor...providers-wreaking-havoc-child-health-1488244
February 16, 2015
ARTICLE
DURHAM, NC - Few health care providers in rural India know the correct treatments for childhood diarrhea and pneumonia ? two leading killers of young children worldwide. But even when they do, they rarely prescribe them properly, according to a new Duke University study.
Medical practitioners typically fail to prescribe lifesaving treatments such as oral rehydration salts (ORS). Instead, they typically prescribe unnecessary antibiotics or other potentially harmful drugs, said Manoj Mohanan, a professor in Duke?s Sanford School of Public Policy, and lead author of the study.
Diarrhea and pneumonia accounted for 24 percent of deaths among children 1 to 4 years old, totaling approximately 2 million deaths worldwide in 2011. Bihar, India ? where the study was conducted ? has an infant mortality rate of 55 per 1000 live births, the highest in the country.
...
?We know from previous studies that providers in rural settings have little medical training and their knowledge of how to treat these two common and deadly ailments is low,? Mohanan said.
?Eighty percent in our study had no medical degree. But much of India?s rural population receives care from such untrained providers, and very few studies have been able to rigorously measure the gap between what providers know and what they do in practice.?
...
http://today.duke.edu/2015/02/wrongtreatment
The Know, Do, and Quality Gaps in International Maternal and Child Health Care Interventions
ONLINE FIRST
James M. Tielsch, PhD1
JAMA Pediatr. Published online February 16, 2015. doi:10.1001/jamapediatrics.2014.3741
Tremendous progress has been made in reducing the mortality rates for young children, especially in low- and middle-income countries, with annual deaths down from 12.6 million in 1990 to 6.3 million in 2013.1 Although it is unlikely that number 4 (reduce child mortality) of the Millennium Development Goals set by the United Nations in 20012 will be achieved by the deadline this year, an even more ambitious goal for the elimination of preventable deaths among newborns and children younger than 5 years by 2030 is likely to be set by the United Nations General Assembly in the fall of 2015.3 Discussions about these laudable goals often center on claims such as, ?we know what works, we just need to do it.? In fact, estimates of coverage of proven interventions for child survival are significantly lower than needed to maximize the effects, with the most important coverage gaps seen in the areas of family planning, interventions for newborns, and case management of childhood diseases, such as diarrhea, pneumonia, and malaria.4 This is often referred to as the know-do gap. In this issue, Mohanan et al5 provide a distressing description of this gap related to the diagnosis and treatment of diarrhea and pneumonia by health care practitioners in Bihar, India.
...
http://archpedi.jamanetwork.com/article.aspx?articleid=2118578
India: Poorly educated rural health providers wreaking havoc on child health
By Jayalakshmi K
February 17, 2015 05:08 GMT
...
Providers exhibited low levels of knowledge during the interviews and fared worse during the practice.
For example, for diarrhoea, while 72% said they would prescribe oral rehydration salts, only 17% actually did so. Those who did prescribe ORS added other unnecessary or harmful drugs.
In practice, none gave the correct treatment: only ORS, with or without zinc, and no other potentially harmful drugs.
Almost 72% of providers gave antibiotics or potentially harmful treatments without ORS.
...
http://www.ibtimes.co.uk/india-poor...providers-wreaking-havoc-child-health-1488244