In 2006, a cross-sector coalition that includes experts from Ministry of Health departments of hygiene, epidemiology, child health, nutrition, and information worked to halt deaths from diarrheal disease in Nicaragua through a comprehensive approach. This team combined efforts with NicaSalud (a local coalition of nongovernmental organizations), PATH, UNICEF, and others to engage public-sector clinics and train health care workers throughout the country on zinc and new, low-osmolarity oral rehydration solution. A parallel demonstration project by vaccine manufacturer Merck & Co., Inc., and the ministry aimed to show the feasibility of rotavirus vaccine introduction in a low-resource setting and to record its public health impact.
The introduction of the rotavirus vaccine in 2006 marked the first time in history that a developing country took up a vaccine in the same year as its adoption in the United States. More than 85 percent of vaccine-eligible children were reached in the project’s first year. Since rotavirus vaccine introduction in Nicaragua, hospitalizations due to rotavirus dropped by 60 percent, and emergency-room visits have been slashed in half!
Citing cross-disciplinary cooperation as fundamental to the program’s achievements, the MOH credited the alliance with building awareness of zinc treatment, ORT, and rotavirus vaccines. Nicaragua’s strategy for integrated training on diarrheal disease control illustrates how a coordinated approach can strengthen the health system.
Contributed by PATH.
Maria, her husband Juan, and their five children knew the harmful effects of dirty, contaminated water in their village of Bijagua, Nicaragua. They used to bring the household water for cooking, bathing, drinking, and washing in buckets from a stream ten minutes away from their home—the same stream where cattle roamed. The children were constantly sick with diarrhea, and getting the water each day was a real burden.
"Our daughter spent so much time carrying water, she was falling behind in her school work. We always worried about her walking alone in the dark of the early mornings and evenings. There are poisonous snakes around here," said Maria.
Episcopal Relief & Development partnered with El Porvenir, an organization that works in Nicaraguan communities to develop water, sanitation, and re-forestation projects. The program also provided Maria and her community with education and training on properly maintaining the water system, water hygiene, and protecting children and families from preventable, water-related diseases. Instances of water-borne illnesses were also tracked by local health monitors. Now Bijagua has safe water and residents can stay healthy. "Our daughter is excelling in school now that she doesn’t have to carry buckets of water. And the children don’t have diarrhea anymore," Maria stated.
Contributed by Episcopal Relief & Development