The impact of an oral rehydration therapy program in Southern Thailand.

Abstract

Although Thailands National Control of Diarrheal Diseases Program introduced in 1980 features oral rehydration therapy (ORT) and the distribution of oral rehydration salts (ORS) recent surveys have indicated that only a small proportion of diarrhea cases are treated by this method. To raise the level of ORS use in a selected area (Pattani Province in Southern Thailand) a 2-day training course was offered to village health volunteers (VHVs) and village health communicators (VHCs). After completion of their training VHVs and VHCs recruited 30-40 women from each village to attend monthly meetings where use of ORS was demonstrated and motivated. In addition local health officers held a meeting in each of the villages with the Tambon Council VHVs VHCs and about 40 residents. A comparison of baseline and follow-up data collected in 2 villages where this training protocol was followed and in 2 control villages where there was no intervention confirm that additional training of village members in combination with the motivation of village leaders can have a marked impact on ORT utilization. Further this impact can be achieved within the existing staff structure (VHVs and VHCs) of Thailands national health program. The percent change in proportions of mothers reporting ORS treatment of their children with diarrhea was over 4 times greater in the experimental areas (from 31% at baseline to 82% at follow-up) than in the control areas (from 31% at baseline to 42% at follow-up). Multiple regression analysis indicated that the positive program effect occurred throughout the socioeconomic strata of the population and did not select out mothers who were more educated or had higher household incomes. The proportions of mothers treating their children with ORS who had been visited in the preceding 2 months by a VHV or VHC were about 40% higher than the proportions of mothers who were not visited. Attendance at group meetings also led to a 40% increase in the likelihood of ORS use. The positive effect of this ORT intervention was noted among both Buddhists and Muslims.