Pneumonia: Little progress on a big killer
Acute respiratory infections (ARI), mainly pneumonia, kill more than 2
million children each year. Yet many countries are only beginning to take
steps to reduce the devastating but largely preventable toll. Many ARI
deaths could be averted if families knew pneumonia's danger signs, if health
workers were trained to diagnose and treat pneumonia, and if clinics stocked
life-saving antibiotics. Since 1992, however, only 16 countries have undertaken
surveys of clinics to determine health workers' training and the availability
of basic antibiotics. And only 23 countries have completed household surveys
to gauge families' awareness of danger signs.
In 10 of the countries that surveyed clinics, fewer than half of health
workers are trained in pneumonia case management. In several countries,
such as Colombia, the Dominican Republic, Indonesia, Malaysia, Thailand
and Zimbabwe, a high percentage of clinics stocked antibiotics, but a much
lower percentage of health workers were trained to treat pneumonia. Pakistan
and Papua New Guinea had low rates for both antibiotics and training. Among
countries with household surveys, only in Egypt do more than half of caretakers
know when to seek treatment.
But there is good news from the world's two most populous countries:
China has trained 88% of health workers in standard case management of
ARI, and India is a close second at 87%. Nearly all clinics surveyed in
both countries stock necessary antibiotics.
At the beginning of this decade, few countries had programmes to reduce
mortality from pneumonia. Of 88 countries where pneumonia is thought to
be common, 59 have now started control programmes, and household surveys
are being carried out in 60 countries.
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