Impact of preventive and early treatment of childhood pneumonia and diarrhea in Ethiopia, analysis from Health Management Information System (HMIS) report 2010 -2016

Abstract

Background: In Ethiopia mortality in children younger than five years it has dropped from 202 in 1990 to 55 in 2019 (EDHS 2019).  Pneumonia and diarrhea are the two leading causes of under-five mortality. They have overlapping risk factors, such as poverty, undernutrition, and poor hygiene. Ethiopia introduced Integrated Community Case management (ICCM) is strategy to treat sick children in communities. Pneumococcal Conjugate vaccine was introduced in 2010, and Rotavirus vaccine was in 2013.This research was conducted to assess the changes in morbidity and mortality in children due to pneumonia and diarrhea based on HMIS data.

Methodology: Diarrhea and pneumonia morbidity, admission, and mortality data of under five children were extracted from 2002/09 EFY to 2008/16 GC, annual Federal Ministry of Health and Health related indicators bulletin. Proportion of morbidity, admission, mortality, and change in percentage analyzed and compared using significant test.

Results: Morbidity due to pneumonia to total under five morbidity increased from 2.6% to 8.7%, and that of diarrhea from 2.3% to 11.8% in six years (2010 to 2016) p-0.000. Admission due to pneumonia decreased from 5% to 4.5%, (10% reduction), p-0.009 and that of diarrhea 3.4%, to 1.3%, (63% reduction), p-0.000. Mortality due pneumonia decreased from 2.7%, to 1.4 %, (48% reduction), p-0.113, that of diarrhea decreased from 1.9% to 0.9%, (53% reduction), p-0.42. The change in morbidity and admission were significant, but that of mortality was not significant.

Conclusion: The increase in morbidity of pneumonia and diarrhea might be due to increase in health service utilization. The decline in admission and mortality of both diseases showed that introduction of new vaccines of, Rota, and early treatment in health posts using ICCM algorisms, have significant contribution. Standard quality treatment, prevention by improving immunization quality and coverage, maximum utilization of health service, is necessary to further decrease, admission and mortality.