A primary health care baseline survey in a rural district in Zambia
Trykker, H.; Simwambana, A.; Kantu, K.; Eberhard, M.
African Journal of Medicine and Medical Sciences 23(2): 147-151
1994
ISSN/ISBN: 0309-3913 PMID: 7625303 Document Number: 293404
During mid-1988 in Zambia, a baseline survey of 388 households in Choma District in the Southern Province was conducted to collect data on immunization coverage among children 12-23 years old, diarrhea morbidity among children younger than 5, use of oral rehydration among these children, and nutritional status among children 24-59 months old. 75% of children were completely immunized against BCG, polio, diphtheria-pertussis-tetanus, and measles and had an immunization card compared to 36% for rural Zambia in 1986. Immunization coverage ranged from 79% for measles to 95% for BCG. The rural health centers (RHCs) reported 38 patients with measles, suggesting either that some children did not fully benefit from the immunization program or problems existed with the cold chain. Fluctuation in the DPT and polio vaccine supply resulted in a dropout rate of 12% between 1st and 3rd dose and 9% between 1st and 2nd dose, respectively, compared to 38% and 31%, respectively, for rural Zambia (1986). 22% of children had had a recent episode of diarrhea. The 2-week diarrhea incidence rate was 0.16 (assuming the diarrhea episode lasted 6 days). The annual diarrhea incidence rate stood at 4.8 episodes/child. 52% of children who had had a diarrheal episode used oral rehydration solution obtained from an RHC or a community health worker. 15% ingested home-made sugar/salt solution. 81% of mothers would first take their child with diarrhea to an RHC. Only 10% of households had access to potable water from a borehole. Leading water sources were shallow water holes (32%), dug wells (25%), and rivers (16%). The water supply evaporated during the dry season for 50% of households. Dumping feces in the bush (67%) and use of a pit latrine (30%) were the main methods of feces disposal. After the harvest, 38% of children 12-23 months old and 74% of those 24-59 months old were well-nourished. A health education program on safe water supplies and better sanitation and an intersectoral agriculture and health program are needed to control diarrhea and to fight malnutrition, respectively.