A well functioning health care system encompasses a wide range of factors with a balance between prevention strategies and treatment. However, it is not clear at what point the two balance in the right measure.
I have been involved in a demand generation campaign for improving treatment practice in the management of diarrhea. As a result, I have appreciated the complexities of changing both care providers’ and health care workers’ behaviour. The treatment of diarrhea, one of the leading causes of under 5 mortality in Uganda, requires rehydration and zinc supplementation. But for a mother in the rural part of the country, treatment means money! Public health facilities where she could easily obtain medication for her sick child without a fee may not be in close proximity, plus she’d need transport funds to get treatment quick. The alternative then becomes looking for options at home or at a near-by drug shop where she’d have to buy the medication, assuming she’s not given a wrong alternative in the name of fitting within her budget.
While creating awareness about the appropriate treatment has been a great approach and has meant saving lives, I occasionally wonder if this is the most appropriate solution in the long run. I think about what the mother would have to go through every time her child gets a bout of diarrhea. The intervention is perfectly ideal if all mothers are able to afford diarrheal treatment, compliance levels are good, appropriate hygiene practices are exercised in homes, public health facilities are within close proximity, there are no supply challenges with commodities and trained health workers are retained within the system long enough to mentor fresh staff.
As I questioned a lot of aspects of the treatment intervention, I wondered how much was being done to address prevention.
While the program has addressed both supply and demand challenges to the management of diarrhea, I am constantly reminded that this is only part of solving the bigger problem. Beyond cost effectiveness and sustainability, I find myself brooding over how I can help this mother make diarrhea episodes history.