India Diarrhoea Burden
Over one million children under the age of five die in India every year. Diarrhoea and pneumonia continue to be major contributors to childhood mortality, representing 36% of under-five deaths in India. There are an estimated 312 million diarrhoeal episodes in India each year of which 6.7 million are severe episodes5. Each episode of diarrhoea contributes to malnutrition in children. In India, around 48% of children are suffering from various degrees of malnutrition, which are largely associated with diarrhoea. These deaths contribute to India’s inability to achieve the Millennium Development Goal (MDG) four target, to reduce deaths to 42 per 1,000 live births by the end of 2015. India’s child mortality is currently at 55 per 1,000 live births. In order to achieve MDG four India needs to address diarrhoeal diseases urgently in children under the age of two.
The World Health Organisation (WHO) estimates that 88% of deaths from diarrhoea are attributable to four issues: consumption of unsafe water; inadequate sanitation; poor personal hygiene and the lack of access to childhood immunisation as a preventative measure.6 While India has made considerable progress in increasing access to drinking water sources and immunisation through various government programmes, the vast majority of the rural and urban slum population are still drinking unsafe water, and are unaware of the benefits of immunisation for their children.
Furthermore, poor children do not have access to the necessary life-saving treatment measures. For example, only 1.3% of children with diarrhoea were treated with Zinc and ORS in rural areas, whilst only 39% of children with diarrhoea in rural areas and 52% of children in urban areas were treated with Oral Rehydration Salts (ORS). This is far off the WHO recommendation that all diarrheal episodes should be treated with both ORS and Zinc.
As in many other developing countries, diarrhoea is a major burden on public health and individual households in India. The direct cost of hospitalisation with an episode of diarrhoea in India is INR 3,633 (equivalent to £36) and consumes a median of 6.4% of annual household income.
Annually rotavirus diarrhoea alone causes an estimated 457,000 to 884,000 hospitalisation cases and two million outpatient visits in children under five. India spends INR 2.0-3.4 billion (USD 41-72 million) annually in medical costs to treat rotavirus diarrhea.