Dehydration due to diarrhea takes the lives of millions of children aged under five years in developing countries, which is, however, now a preventable and treatable disease. The present comparative analysis of two Demographic Health Survey (DHS) cycles examined changes in ORS coverage in Zimbabwe, Zambia, and Malawi. 

It examined the national and sub-regional prevalence of ORS use during an episode of diarrhea (within two weeks of the survey) using DHSs for 2007–2010 (1st Period) and 2013–2016 (2nd Period), followed by statistical analysis.

The study observed-

• Increase in Crude ORS coverage from 21.0% in 1st Period to 40.5% in 2nd Period in Zimbabwe; increase from 60.8% to 64.7% in Zambia, and decrease from 72.3% to 64.6% in Malawi.
• Change rates in coverage among provinces in Zimbabwe ranged from 10.3% over the three cycles (approximately ten years) in Midlands to 44.2% in Matabeleland South; in Zambia from − 9.5% in Eastern Province to 24.4% in Luapula; and in Malawi from − 16.5% in the Northern Province to − 3.2% in Southern Province.
• Odds Ratios for ORS use as 3.95 for Zimbabwe, 2.83 for Zambia, and 0.71 for Malawi.

This study shows that ORS coverage increased in Zimbabwe, stagnated in Zambia, but declined in Malawi. Surveying national and province-level trends of ORS use shows geographic inequalities and helps identify priority areas for targeting resource allocation. Providing safe drinking water, adequate sanitation, and hygiene will help reduce the causes and the incidence of diarrhea. Health policies should be developed and implemented to reduce diarrhea burdens and to increase access to appropriate treatments, such as vaccines for rotavirus and cholera.

BMC Public Health. 2020 Nov 16;20(1):1716. Doi: 10.1186/s12889-020-09811-1. PMID: 33198701; PMCID: PMC7670726.