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  1. 1

    Local production of oral rehydration salts.

    Tomaro J

    [Unpublished] 1990 May. [2], 12 p. (PRITECH Field Implementation Aid)

    Control of Diarrheal Disease (CDD) programs need to move more and more toward self-sufficiency. Thus they want a reliable supply of low cost, locally produced oral rehydration salts (ORS). 2 obstacles hinder the process: low demand and an inadequately developed pharmaceutical industry. It takes about US$200,000 to begin ORS production. In 1987, pharmaceutical plants in developing countries made 75% of all ORS produced. In Indonesia, for example, 12 private and parastatal manufacturers can produce ORS, but low demand is forcing some to decrease production. In Bangladesh, however, only 1 parastatal and 1 private company produces all ORS used in the country, but they cannot keep up with demand. Other developing countries producing their own ORS include Costa Rica, Tunisia, Zambia, Mali, Egypt, and Ghana. Any group that considers local ORS production must first examine various factors including an assessment of potential demand, the extent that diarrhea is treated with oral rehydration therapy (ORT), and the government's position on ORS production and distribution. The group should contact the local UNICEF office to gain its support and guidance. It should also work with WHO and Ministry of Health officials and speak with the chief pharmacist or head of the pharmacy board. This group also needs to consider economic factors such as pricing and costs of importing raw materials. It should also see to a detailed cost analysis and market research. The group also needs to determine production capability in the country which includes the ability of companies to adhere to the international Good Manufacturing Practices code. In the beginning of project development, the group must consider ORS promotion with ORS production, e.g., it should scrutinize the potential producer's record for marketing and organize field research. The group can obtain technical assistance from UNICEF, UNIDO, and USAID funded projects such as PRITECH, PATH, HEALTHCOM, and SOMARC.
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  2. 2

    Measuring childhood mortality: a guide for simple surveys.

    David PH; Bisharat L; Hill AG; Bennett S

    Amman, Jordan, United Nations Children's Fund, Regional Office of the Middle East and North America, 1990. 172 p.

    This handbook is intended to aid the United Nations International Children's Emergency Fund (UNICEF) handle surveys of childhood mortality added to vaccination coverage surveys (expanded program of immunization- -EPI) surveys or to diarrheal mortality and morbidity surveys (MMT). By including all women of reproductive ages in each household as part of EPI coverage surveys, the survey window has widened. The core modality module (CMM) locks neatly into this flow. It is not intended to be a substitute for other ways to measure child mortality. Infant and under- age-5 mortality are indicators of social welfare. The reasons why these surveys are called "simple" or "rapid" are listed. Measurement of mortality is covered in Chapter 1. The Brass method, the birth history, the preceding births technique, and the design and execution of a simple mortality survey are discussed here. Formulating the questionnaire is covered in the next chapter. Discussed here are the mortality module; translation, layout and pretesting of the questionnaire; the screening questionnaire, and the mortality questionnaire (Modules A and B). Chapter 3 discusses the design of a sample survey to measure childhood mortality. Discussed here are cluster and stratified sampling, modifying EPI surveys for purposes of mortality estimation, selecting the sample and the clusters, determining sample size, and the requirements of a good sample. Collecting the data is discussed in chapter 4. Topics discussed include field work, preparation of the interview instructions, field supervisor and interviewers, selection and training of field staff, training course outline, selecting households in the sample, quality control; supervisor's responsibilities, how to handle an interview, and how to fill in the questionnaire. The 5th chapter discusses data analysis. Under data analysis, data tabulation of the mortality data, the Brass estimates of childhood mortality and trends, preceding birth technique estimates, estimates from the short birth history, technical note: calculating sampling error for proportions and points to remember are described. How to write the report is discussed in chapter 6.
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