Management of ARI for control of mortality in underfives

WHO advocated a standard case management for control of ARI related mortality. India has started an ARI control programme in 15 districts. Conflicting reports appeared regarding the effectiveness of case management strategy. Authors reported earlier that it was not effective. The coverage was only about 57% in pneumonias, and 23% in severe pneumonias. Health agencies & health workers have a low utilizaticn (13.7%), and RMPs were used in large numbers (36.9%). Most of the deaths were in those treated by RMPs (75%). The efficacy of standard case management (88%) is highlighted. The problem of coverage and assumptions behind the strategy were discussed and recommendations for improvement were suggested.