Children aged < 5 years with ARI symptoms taken to facility (percentage)
Rationale for use
Acute respiratory infections (ARI) are responsible for almost 20% of all deaths of children aged less than 5 years worldwide. The proportion of under-fives with ARI that are taken to an appropriate health-care provider is a key indicator for coverage of intervention and care-seeking, and provides critical inputs to the monitoring of progress towards child survival-related Millennium Development Goals and Strategies.
Definition
Proportion of children aged 0–59 months who had ‘presumed pneumonia’ (ARI) in the last 2 weeks and were taken to an appropriate health-care provider.
Associated terms
Strictly speaking, ‘ARI’ stands for ‘acute respiratory infection’. During the UNICEF/WHO Meeting on Child Survival Survey-based Indicators, held in New York, 17–18 June 2004, it was recommended that ARI be described as ‘presumed pneumonia’ to better reflect probable cause and the recommended interventions. The definition of ARI used in the Multiple Indicator Cluster Surveys (MICS) was chosen by the group and is based on mothers’ perceptions of a child who has a cough, is breathing faster than usual with short, quick breaths or is having difficulty breathing, excluding children that had only a blocked nose.
Appropriate health-care provider: the definition of ‘appropriate’ care provider varies between countries.
Data sources
Household surveys such as DHS and MICS.
Methods of estimation
Empirical data.
Disaggregation
By age, location (urban/rural, major regions/provinces), and socioeconomic characteristics (e.g. mother's level of education, wealth quintile).
References
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Childhood morbidity and treatment patterns
Boerma JT, Sommerfelt AE, Rutstein SO. Childhood morbidity and treatment patterns. Demographic and Health Surveys Comparative Studies No 4. Columbia, Institute for Reserve Development/Macro International, 1991. -
How many child deaths can we prevent this year?
Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, and the Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet, 2003, 362:65–71. -
Meta-analysis of intervention trials on case-management of pneumonia in community settings
Sazawal S, Black RE. Meta-analysis of intervention trials on case-management of pneumonia in community settings. Lancet, 1992, 340:528–533. -
Inequities among the very poor: health care for children in rural southern Tanzania
Schellenberg JA, Victora CG, Mushi A, et al. Inequities among the very poor: health care for children in rural southern Tanzania. Lancet, 2003, 361:561–566. -
State of the world's children, 2003
UNICEF. State of the world's children, 2003. New York, United Nations Children's Fund, 2003.
Database
Comments
The framework for the review of child survival indicators during the UNICEF/WHO Meeting on Child Survival Survey-based Indicators was the set of prevention and treatment interventions outlined in the Lancet series on child survival.
These indicators are usually collected in DHS and MICS surveys; however, the accuracy of reporting in household surveys varies and is likely to be prone to recall bias. Seasonality related to the prevalence of ARI may also affect the results and their comparability between and within countries.