Global health challenge: Kenya aims to improve child health

Recent evidence from London has shown how simple checklists of appropriate health care practices can dramatically reduce deaths in the hospital. (Sometimes called "care bundles.") The Kenyan government is now implementing a similar approach for public health practitioners tackling the problem of diarrheal disease and death among children.

Around the world, nearly 20 percent of all deaths in children under age 5, a total of 1.5 million each year, are caused by diarrhea. In Kenya, it's the third leading cause of child death. UNICEF and the WHO recently outlined seven steps necessary to combat diarrheal deaths in children:

Prevention steps:

• Rotavirus and measles vaccinations

• Promotion of early and exclusive breastfeeding and vitamin A supplementation

• Promotion of hand-washing with soap

• Improve water quantity and quality, including treatment and safe storage of household water

• Promotion of community-wide sanitation

Treatment steps:

• Fluid replacement to prevent dehydration

• Zinc supplements

Progress in these areas remains slow. Worldwide, rotavirus causes 40% of hospital admissions from childhood diarrhea, but the vaccine is not available in most developing countries. The WHO hopes to change this, recommending in 2009 that rotavirus be included in every nations vaccine program. In Kenya 7500 children a year die from the virus. Nearly 1 billion people lack access to safe drinking water, and twice that many lack access to safe sanitation facilities. Proper sanitation is still lacking across much of Kenya as well. Globally, 129 million children under age 5 are underweight (a leading indicator of future health problems, and susceptibility to disease), and only 37% of infants in developing nations are exclusively breastfed for the first 6 months of life.

In an effort to improve health outcomes for children, the Kenyan Ministry of Public Health and Sanitation has worked with the WHO, UNICEF, PATH, Population Services International, and the Micronutrient Initiative to distribute simple charts that cover those basic, proven steps needed to prevent and treat diarrheal diseases. A simple approach, perhaps, but with the potential to have huge impact in saving children from completely preventable form of disease and death whose causes and treatments are technically simple, if sometimes logistically difficult to implement.