Child survival in a rural area in Zimbabwe: are we winning?
Tumwine, J.K.; Mackenzie, S.
Central African Journal of Medicine 38(1): 30-36
1992
ISSN/ISBN: 0008-9176 PMID: 1633616 Document Number: 403592
Health teams have been working to improve child survival in the rural Chimanimani district of Zimbabwe since 1984. In order to determine whether these efforts have had any effect upon child survival, causes of morbidity and mortality in under-5-year-old children were studied prospectively. Specifically, records were reviewed for all 902 children admitted to Chimanimani Hospital between May 1, 1985 and April 30, 1988, and community-based surveys conducted on nutrition status, immunization coverage, and knowledge and use of oral rehydration solution (ORS). Cases of malnutrition, acute respiratory infections (ARI), and diarrhea constituted 69.7% of those admitted under age 5. Further, 67.4% of hospital deaths were among under-fives even though they make up only 17.45% of the total population. The pattern of mortality paralleled that of morbidity. Malnutrition was, however, more common in dry communal areas and on commercial estates. Full immunization coverage rates of 12-23 month olds increased from 44.3% in 1984 to 70% in 1989, and up to 69% of mothers correctly prepared and used ORS. While immunization coverage increased over the period, little impact was made in reducing malnutrition, ARI, and diarrhea. Much can nonetheless be achieved in a remote rural district when given political will, community involvement, and dedicated staff.