Paediatr Perinat Epidemiol. 1987 Sep; 1(2): 153-61.

Village health workers are able to teach mothers how to safely prepare sugar/salt solutions.

Yach D, Hoogendoorn L, Von Schirnding YE.

Institute for Biostatistics, Medical Research Council, Tygerberg, South Africa.

In the predominantly rural Hewu district of Ciskei 54% of infant deaths are diarrhoea-related. The aim of this study was to determine whether village health workers (VHWs) could teach mothers to safely prepare homemade sugar-salt solutions (SSS). VHWs from 11 villages were selected for training while 11 randomly selected villages acted as controls. VHWs selected for training were taught to prepare SSSs and to teach mothers with children under 5 years about the use of such solutions. A card illustrating the main points was given to all mothers. Six weeks after training, randomly selected mothers in control villages (n = 320) and experimental villages (n = 327) were interviewed and asked to prepare SSS. Experimental and control villages had similar children's diarrhoeal disease rates (using a 2 week recall period). In experimental villages 81.5% of mothers compared to 29.7% in control villages had received SSS cards (i.e. been visited). Of recently occurring diarrhoeal-episodes 76.6% were initially treated with a SSS (correct formula used in 81% of cases) in experimental villages compared to 50.5% (correct formula used in 48% of cases) in control villages (P less than 0.05 for SSS use). Greater use of enemas and home remedies occurred in control villages (P less than 0.05). Of solutions made in experimental villages 7% had sodium concentrations over 100 mmol/litre compared to 36% in control villages. Results show that VHWs can effectively train mothers to safely prepare SSS and the VHW program has been expanded to other areas.