Evaluation of diarrhoea management of health professionals trained at the Diarrhoea Training Unit of Rawalpindi General Hospital.

To promote the use of oral rehydration therapy (ORT), a training programme was launched by The Pakistan National Programme for Control of Diarrhoeal Disease (CDD) by establishing the Diarrhoea Training Units (DTUs). Physicians trained at DTU were designated to establish functioning oral rehydration therapy (ORT) corners at their health centres and train health workers in delivery of facilities on standard diarrhoea case management. The study was designed to evaluate the functioning of ORT corners three years after their establishment. The study revealed that ORT corners have failed to achieve the main objectives of DTU programme. Twenty-four out of 49 ORT corners were non-functional after three years of their establishment, mainly due to frequent transfers of trained staff. In 22 ORT corners evaluated, performance of health professionals was far from satisfactory, 19 out of 22 doctors were found to have inadequate performance in diarrhoea management and only 3 out of 7 LHVs performed adequately. LHVs could not consistently deliver health education messages to mothers. There seems to be a lack of interest and willingness to participate actively, as more than 50% of both doctors and LHVs did not consider ORT work as their job. We conclude that the ultimate objectives of improved and appropriate diarrhoea case management through ORT corners have not been achieved.