Abstract
BackgroundIt was unclear how and to what extent the “Child Care” intervention (CCI) in rural Primary Health Care Program affected the prevalence of childhood diarrhea in rural western China.MethodsThe available data of 10,829 and 10,682 households was collected from shared 34 counties of 9 provinces of western China in 2001 and 2005 respectively. A log-binomial regression model was used to predict the effect of CCI on prevalence of childhood diarrhea.ResultsIn 2001, the prevalence rate of diarrhea among children less than 36 months of age was 17.01% in intervention group and 17.72% in control group, and in 2005 this crude rate declined to 4.85% in the former and 6.84% in the latter. Log-binomial regression analysis showed that CCI decreased the overall prevalence of childhood diarrhea by 27% (adjusted relative prevalence ratio (rPR) = 0.73 95% CI 0.59, 0.89). The stratification regression by social-economic status (SES) of the households showed that this effect varied with SES of the households. In the medium or rich households, this intervention was effective significantly (the medium: adjusted rPR = 0.63,95%CI 0.41,0.95; the rich: adjusted rPR = 0.72,95%CI 0.54,0.97), but in poor households it seemed to be less effective (adjusted rPR = 0.86,95%CI 0.55,1.36).ConclusionIn rural Primary Health Care Program, CCI was effective in improving childhood diarrhea but this effect was inequitable among SES of the households. So, attention should be paid to the inequality when CCI was adopted to reduce childhood diarrhea in rural China.
Highlights
It was unclear how and to what extent the “Child Care” intervention (CCI) in rural Primary Health Care Program affected the prevalence of childhood diarrhea in rural western China
CCI “Child Care” Intervention, social-economic status (SES) Socio-economic Status, rPR relative prevalence ratio, CI confidence interval aEleven variables (SES, family size, child size, drinking boiled water, age of mother, maternal education, ethnicity, age and gender of child, township-orabove level delivery and natural delivery), and intervention variable, year variable and their interaction were entered together into a log-binomial regression model to evaluate the adjusted effect of CCI on childhood diarrhea bExcept for SES, other variables were entered together into a log-binomial regression model to evaluate the adjusted effect of CCI on childhood diarrhea childhood diarrhea
Our recent study aiming at explaining the prevalence of childhood diarrhea and its decrease in rural western China highlighted the importance of a set of social and economic determinants that were considered in the current study to be potential confounders of the CCI effect [12]
Summary
It was unclear how and to what extent the “Child Care” intervention (CCI) in rural Primary Health Care Program affected the prevalence of childhood diarrhea in rural western China. Care” intervention (CCI), “Safe Motherhood” intervention and “Rational Drug Use” intervention were implemented. Of these interventions, only CCI was a child-oriented group intervention. Lowering the prevalence of childhood diarrhea to reduce diarrheal mortality will be of critical importance for improving child survival and health. Though the RPHC program had been implemented twice (the first round:1999 to 2000; the second round: 2001 to 2005) in rural western China, it was unclear how and to what extent CCI included in the second round RPHC program affected the prevalence of childhood diarrhea in these areas
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