Eco-social and behavioural determinants of diarrhoea in under-five children of Nepal: a framework analysis of the existing literature.

Shyam Sundar Budhathoki,Paras K Pokharel,Pawan Upadhyaya,Ajay Kumar Yadav,Meika Bhattachan

doi:10.1186/s41182-016-0006-9

Shyam Sundar Budhathoki, Paras K Pokharel + Show 3 more

Open Access

https://doi.org/10.1186/s41182-016-0006-9

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Abstract

BackgroundWhile diarrhoea is the second major killer among the under-five children in the world with an estimation of 760,000 deaths annually, it stands as a major killer in Nepal with an annual incidence of 500 per 1000 under-five children with diarrhoea. Diarrhoea is responsible for a wide range of morbidity and mortality among children in Nepal. The objective of this review work is to identify the eco-social and behavioural determinants of diarrhoea among the under-five children of Nepal.MethodsA literature review was conducted using the Dahlgren and Whitehead model (1991) between June and October 2015. PubMed, Nepal Journals online and Google Scholar were used to search for literature published between 1989 and July 2015 using defined keywords.ResultsChildren of age group 6–23 months are at higher risk, as supplementary diets are introduced to the children from the age of 6 months. Male children have better access to healthcare services. Malnourished children also have a higher chance of developing persistent diarrhoea. Provision of safe water and sanitation has direct link with the prevention and control of diarrhoea. Male gender with high income positively influences the treatment-seeking behaviour. Mother’s education and hand-washing practice have direct influence in child health. Hand-washing practices with soap which are protective are influenced by the cultural beliefs. Involvement of community health volunteers increases the access to the health system, thereby reducing the diarrhoeal burden in the community.ConclusionAge, gender, hand-washing behaviour, nutritional status of children, education of mothers, water and sanitation, healthcare services, cultural and societal values and income of the household were identified determinants for diarrhoea in under-five children of Nepal.

Highlights

While diarrhoea is the second major killer among the under-five children in the world with an estimation of 760,000 deaths annually, it stands as a major killer in Nepal with an annual incidence of 500 per 1000 under-five children with diarrhoea
This paper explores the determinants of diarrhoea from an eco-social and behavioural perspective using the Dahlgren and Whitehead (1991) model of determinants of health
The eco-social and behavioural determinants of diarrhoea among under-five children in Nepal are identified as follows: three factors related to the under-five children, two Nutritional status of children In Nepal, 41 % of children under 5 years are stunted, 11 % are wasted and 29 % are underweight [6]

Summary

Introduction

While diarrhoea is the second major killer among the under-five children in the world with an estimation of 760,000 deaths annually, it stands as a major killer in Nepal with an annual incidence of 500 per 1000 under-five children with diarrhoea. Diarrhoea is responsible for a wide range of morbidity and mortality among children in Nepal. The objective of this review work is to identify the eco-social and behavioural determinants of diarrhoea among the under-five children of Nepal. There are around 1.7 billion cases of diarrhoeal disease every year and is the second major killer among the under-five children in the world with an estimation of 760,000 deaths annually [2] accounting for one tenth of all deaths worldwide, especially in South Asia and Sub-Saharan Africa [3]. The under-five mortality and infant mortality are 54 and 46 deaths per 1000 live births, respectively [6]

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