Revisiting primary health care in the 21st century: How Kenya is struggling with control of diarrheal disease in children

Revisiting primary health care in the 21st century: How Kenya is struggling with control of diarrheal disease  in children.
Objectives: To determines factors that lead to increased incidence of diarrhea and mortality 0f diarrhoea and how to control it in Kenya
Methodology: Mothers, care takers and community leaders were asked what diseases they consider serious to their children, how they perceive diarrhoea in children and how to treat it. Health workers were assessed on how they managed diarrhoea in children.
Findings: Nearly all mothers did not view diarrhoea to be a health problem to their children despite being the third cause of mortality in children. The life saving practices of giving ORS and Zinc were not envisioned as “adequate treatment” by mothers who seek care in primary health care units. In addition, health workers were found to be under pressure to give additional treatment including giving “pills” even when they knew and believed that this was not useful for managing the diarrhoea but went ahead to do so to be acceptable to the community even if this went against their knowledge. The community resource person strategies for managing diarrhoea had “died” with the CDD strategies of the 80’s and was overtaken by other competing issues including malaria and HIV.
In addition, the watery diarrhoea that kills more children was not viewed to be serious as the bloody diarrhoea that is less common and kills fewer children. This perception and reality mismatch was found to lead to neglect of watery diarrhoea in children.
Conclusion: Efforts need to be increased to sensitize caretakers and family about the danger of diarrhoea in children.  Innovative approaches empowering health workers to resist pressure from the communities in order to correctly manage cases of diarrhoea need to be employed to avoid improper management.