Abstract

In many developing countries health data are insufficient. These data are needed to get valid information to make decisions about health programmes. Baseline surveys are in terms of economy and resources a method which is fruitful. These baseline surveys should not only be performed at country and province level. Baseline surveys at district level is needed to monitor local needs. The present baseline survey was focus on immunization, diarrhoea incidence and diarrhoea treatment, sanitation and children nutrition status. 388 households were visited in a random 30 cluster baseline survey in Choma district of Zambia. It revealed that 79% of the children aged 12-23 months was fully immunized and the drop-out rate in polio and DPT vaccination routines was as low as 9 and 12% respectively. The incidence of diarrhoea disease was high and estimated at 4.8 episodes per child per year. ORS and SSS were used as treatment in 52% and 15% of all cases. More than 90% of mothers would seek help at RHCs or PHCs in case of diarrhoea. About 2/3 of the households had no safe water supply and 2/3 no pitlatrine. Only a few had a refuse pit. The nutrition status of children were assessed by using upper arm circumference measurements. Only about 40% of the children age 12-23 month and about 75% of children aged 24-59 months respectively were adequately nourished. The district had in this survey a fair immunization programme but intensified sanitary and nutritional programmes seem justified. Periodic baseline surveys with 2-3 years interval is recommended to determine the impact and future direction of the programme.

PIP:

During mid-1988 in Zambia, a baseline survey of 388 households in Choma District in the Southern Province was conducted to collect data on immunization coverage among children 12-23 years old, diarrhea morbidity among children younger than 5, use of oral rehydration among these children, and nutritional status among children 24-59 months old. 75% of children were completely immunized against BCG, polio, diphtheria-pertussis-tetanus, and measles and had an immunization card compared to 36% for rural Zambia in 1986. Immunization coverage ranged from 79% for measles to 95% for BCG. The rural health centers (RHCs) reported 38 patients with measles, suggesting either that some children did not fully benefit from the immunization program or problems existed with the cold chain. Fluctuation in the DPT and polio vaccine supply resulted in a dropout rate of 12% between 1st and 3rd dose and 9% between 1st and 2nd dose, respectively, compared to 38% and 31%, respectively, for rural Zambia (1986). 22% of children had had a recent episode of diarrhea. The 2-week diarrhea incidence rate was 0.16 (assuming the diarrhea episode lasted 6 days). The annual diarrhea incidence rate stood at 4.8 episodes/child. 52% of children who had had a diarrheal episode used oral rehydration solution obtained from an RHC or a community health worker. 15% ingested home-made sugar/salt solution. 81% of mothers would first take their child with diarrhea to an RHC. Only 10% of households had access to potable water from a borehole. Leading water sources were shallow water holes (32%), dug wells (25%), and rivers (16%). The water supply evaporated during the dry season for 50% of households. Dumping feces in the bush (67%) and use of a pit latrine (30%) were the main methods of feces disposal. After the harvest, 38% of children 12-23 months old and 74% of those 24-59 months old were well-nourished. A health education program on safe water supplies and better sanitation and an intersectoral agriculture and health program are needed to control diarrhea and to fight malnutrition, respectively.