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Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

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  • University of Southern California, Department of Pharmaceutical Economics and Policy, Los Angeles, California; Leonard D. Schaeffer Center for Health Policy and Economics, Los Angeles, California; University of California, Berkeley, School of Public Health, Berkeley, California

Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13–17) than public providers and 12% points more likely to provide other treatments (95% CI 10–15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.

Author Notes

* Address correspondence to Neeraj Sood, 3335 S. Figueroa Street, Unit A Los Angeles, CA 90089-7273. E-mail: nsood@healthpolicy.usc.edu

Authors' addresses: Neeraj Sood, Leonard D. Schaeffer Center for Health Policy and Economics, Los Angeles, CA, E-mail: nsood@healthpolicy.usc.edu. Zachary Wagner, UC Berkeley, School of Public Health, Berkeley, CA, E-mail: zwagner@berkeley.edu.

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