Showing papers in "Turkish Journal of Pediatrics in 1986"

Diarrheal disease control and family planning: the status of women and community participation.

Abstract: This article discusses current campaigns for diarrheal disease control and family planning from the perspective of the social and educational status of women in Turkey. Survey data indicate that infant mortality is highest in regions with highest illiteracy rates; similarly acceptance of family planning in 1 region was 79% among literate women but only 24% among illiterate women. These findings suggest that the way women cope with their infants and with fertility control is directly related to their status. Mothers require education in these areas and support. Particularly effective is a self-help approach that relies on the unofficial or traditional sector of society including the indigenous female lay care network. The traditional birth attendant is often a key person in this network. In a pilot project in Turkey trained midwives taught birth attendants the basic principles of diarrheal disease control and family planning. The selected women then educated the other women of the village through the usual means of communication of the female network. The project found marked improvement in knowledge and practice in diarrheal disease control and family planning and a sense of empowerment among village women. Thus it is recommended that both social marketing and self-help methods be used in Turkeys primary health care campaigns.

Oral rehydration therapy.

Abstract: In this lecture presented to the 30th Congress of the Turkish National Pediatric Society in 1986 the author describes how oral rehydration therapy (ORT) has demonstrated its efficacy and been adopted even by physicians in the developed world. The traditional approach of clear liquids by mouth is an imprecise and inappropriate means of rehydration. During the 1st 8-24 hours after intestinal water losses a solution containing sodium and potassium chloride bicarbonate and glucose is necessary to meet deficits; other sources of liquid such as breast milk and rice water can be offered to satisfy thirst after rehydration has been achieved. Studies in the US have repeatedly confirmed the benefit and cost-effectiveness of ORT. Also successful has been the use of oral electrolyte solutions at the onset of diarrhea before dehydration becomes a problem. An appropriate sodium and potassium concentration with 2% glucose facilitates absorption across the intestinal mucosa without an increase in the intraluminal osmotic load. Calories need to be provided within 24 hours after the initiation of ORT especially in malnourished infants. Clean water is essential if infection is to be overcome. Finally it is stressed that medications to slow intestinal motility are not indicated since diarrhea helps to eliminate offending organisms and their toxins.