The Punjab province has the largest number of diarrhoea related morbidity and mortality rates for children under-fives in Pakistan. The Pakistan Demographic and Health Survey (PDHS) 2012-2013 revealed that diarrhoea prevalence in Punjab has increased by 20% over the last 3 years.
The average prevalence rates of diarrhoea in the two weeks before the survey was 22% and the illness accounts for 26,796 annual deaths among children under five in the province. Within Punjab, the prevalence rate of diarrhoea in Khanewal and Hafizabad districts is at 31% and 33% respectively (baseline survey) which is above the provincial average and translates into a total of 199,650 children under-five across the two districts (148,500 in Khanewal and 51,150 in Hafizabad) resulting in annual under 5 deaths of 1,303 for Khanewal and 449 for Hafizabad. These life-threatening cases of diarrhoea can be prevented through simple, effective and low-cost interventions, which will in turn reduce deaths from diarrhoea (i,e. 7 point plan). The 7-point plan of the World Health Organisation (WHO) and UNICEF is being implemented through RSP’s proven model of three (3) tiers of social mobilization process (i,e. the COs, VOs and LSOs) in the target Union Councils of both districts.
The Village Health & Hygiene Committee (VHHC) will mobilize the local communities and create demand for WASH interventions to prevent and control diarrhoea. As the 7-point plan is focussed on treatment and prevention proposes; a multi-sectoral package of interventions to reduce childhood diarrhoea deaths and make a lasting reduction in the diarrhoea burden in the medium to long term. The plan proposes two treatments for diarrhoea (fluid replacement to prevent rehydration and Zinc treatment) and a prevention package with five main elements (rotavirus and measles vaccinations; promotion of early and exclusive breastfeeding and vitamin A supplementation; promotion of hand washing with soap; improved water supply quantity and quality; and community-wide sanitation promotion).
Therefore RSPN and Save the Children established a partnership to test the implementation of a 7-point plan in selected 40 union councils of Khanewal and Hafizabad districts initially for a period of six months i,e (April 2015 -October 2015) aimed for 30% reduction in the prevalence of diarrhea and 13% reduction in diarrhea-related mortality rates among children under-five by 2018.
The Project is planned to achieve:
Increased access to quality diarrhea prevention and control services for at least 80% of households in target UCs
Improved community awareness and practices for prevention and control of diarrhea in target UCs and
Increased access, accountability, enhanced commitment, and ownership at the Provincial, District, and Community level.
The key activities include:
Selection of the target villages, formation and training of VHHCs & UCHHCs;
Identification and training of CRPs on CLTS and 7-Point Plan of Action for diarrhea prevention;
Support the construction of hand pumps and water purification for safe drinking water in selectively marginalized communities;
Procurement and supply of purification filters and tablets for the poor to ensure safe drinking water;
Training of the masons and entrepreneurs;
Construct latrines for marginalised households;
Support DoH in engagement with and regulation of private providers in the target districts;
celebration of different international events by H&H committees at UC and district level and Formation of children’s health and hygiene club in target schools.
The expected outcomes are as under:
To increase access to safe drinking water for 80% of households in Target UCs of districts Hafizabad and Khanewal;
To increase access to adequate sanitation in at least 80% of households in target UCs of districts Hafizabad and Khanewal;
To improve the knowledge, skills, and practices of facility and community workers on diarrhoea prevention and control in target UCs of districts Hafizabad and Khanewal;
To increase access to routine immunization services at least 90% in target UCs of districts Hafizabad and Khanewal;
To improve community awareness and practices on diarrhoea prevention and control for at least 90% of households;
To increase effective participation of children as change agents for diarrhoea prevention and control in at least 80% of villages in target UCs of districts Hafizabad and Khanewal;
Community structures are operational to influence planning and decision-making at all levels in districts Hafizabad and Khanewal.
