Peer-reviewed article
Trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone.
Osborne A, Bangura C ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines trends in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone using data from 2008, 2013, and 2019. Overall coverage increased from 56.5% to 59.7% over the period, but significant inequalities persist across different population groups. Children of younger mothers, wealthier families, and those in urban areas showed declining coverage, while children from poorer and less educated families improved. Gender and regional disparities remain, with rural and disadvantaged populations showing better progress than their wealthier counterparts.
Key points
- National coverage of oral rehydration therapy and continued feeding increased from 56.5% in 2008 to 59.7% in 2019
- Children of mothers aged 20-49 had higher coverage than those with mothers aged 15-19
- Coverage declined among children of wealthy, more educated, and urban-dwelling mothers compared to poor, less educated, and rural populations
- Male children had higher coverage than female children
- Regional inequality decreased slightly from 21.5 percentage points in 2008 to 21.2 percentage points in 2019
Limitations
This study describes trends and inequalities in coverage of oral rehydration therapy and continued feeding but does not evaluate an intervention or its effectiveness. The analysis relies on self-reported data from demographic health surveys and cannot explain the mechanisms behind the observed inequalities or declining coverage among wealthier populations.
Abstract
Background Sierra Leone has improved child health outcomes in recent decades. However, diarrhoeal diseases remain a public health concern, particularly among children under five. This study investigates the trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone in 2008, 2013 and 2019. Methods The analysis utilised data from the Sierra Leone Demographic Health Survey rounds conducted in 2008, 2013, and 2019. The software utilised for the calculation of various measures of inequality, including simple difference, ratio, population-attributable risk, and population-attributable fraction, was the World Health Organization Health Equity Assessment Toolkit. An inequality assessment was conducted for six stratifiers: maternal age, maternal economic status, maternal level of education, place of residence, sex of the child, and sub-national region. Results Our findings reveal that children under five with diarrhoea receiving oral rehydration therapy and continued feeding increased from 56.5% in 2008 to 59.7% in 2019 in Sierra Leone. Children of mothers aged 20-49 had more coverage over time than those with mothers aged 15-19. Children of mothers who are wealthy, more educated, and living in urban areas show a decrease in coverage with time compared to the poor, the lowly educated, and those residing in rural areas. Male children had higher coverage than female children. Regional inequality decreased slightly from 21.5 percentage points in 2008 to 21.2 percentage points in 2019. Conclusion The findings revealed a mixed picture of progress in oral rehydration therapy and continued feeding for children under five in Sierra Leone. While national coverage has increased, inequalities persist. Children of older mothers and those from disadvantaged backgrounds have experienced improvements, while children of younger, wealthier, and more educated mothers in urban areas have seen a decline in coverage. The gender and regional inequalities remain. Expanding community-based health programs, providing subsidised or free supplies, and strengthening health systems in underserved areas are key strategies to ensure equitable and effective healthcare for all children in Sierra Leone.