In the LAC region, infectious diseases such as diarrhoea and pneumonia remain important causes of illness and death among children under five, even though effective and widely recognised treatments are available (PAHO, 2017[1]) Health systems can greatly reduce these risks by ensuring timely access to basic child health services, including appropriate home management and care provided by trained health professionals. Recommended interventions – such as oral rehydration therapy (ORT) for diarrhoea, vaccination, zinc and vitamin A supplementation, and appropriate antibiotic treatment for acute respiratory infections – are low-cost, well established and widely promoted in primary healthcare. As a result, the extent to which children receive these treatments or caregivers seek professional advice when illness occurs provides an indication of access to and use of essential health services, as well as the availability of basic resources and information for caregivers.
ORT combined with continued feeding is a simple and effective treatment for childhood diarrhoea, helping prevent dehydration and reducing mortality among children under five. However, the use of this recommended treatment varies widely across LAC countries. On average, 46% of children with diarrhoea in LAC receive oral rehydration therapy and continued feeding, although coverage ranges from around one‑third in Argentina and Cuba (33%) and Guyana (37%) to over half in the Dominican Republic (54%), Honduras and Trinidad and Tobago (52%), and 61% in Peru. In El Salvador, coverage (only ORT) is around 70‑75% in rural and urban areas. Important differences between rural and urban areas are also observed in several countries, such as Cuba, Jamaica and Peru (Figure 5.9).
Seeking advice or treatment from a health facility or provider is an important step in the timely management of childhood diarrhoea, particularly when symptoms become severe. Across the LAC countries with available data, around 30% of caregivers receive care from a health provider when a child under five has diarrhoea. Rates vary substantially across countries, ranging from 25% in Trinidad and Tobago and 32% in Jamaica to 45% in Guyana and 51% in Honduras, and over half in Cuba, Argentina and the Dominican Republic (around 53‑57%). In some countries, differences between boys and girls are observed, although these variations are generally small. The relatively low levels of care‑seeking in several countries suggest that many cases of childhood diarrhoea are managed at home without professional guidance, underscoring the importance of caregiver knowledge and access to primary care services.
Care‑seeking from a health facility or provider is essential for the timely diagnosis and treatment of acute respiratory infections (ARI), which remain a leading cause of illness and death among young children. Across LAC countries with available data, the share of children under five with ARI symptoms for whom advice or treatment was sought from a health professional varies widely. Care‑seeking is very high in Argentina (94%) and Cuba (90%) and remains above 80% in the Dominican Republic (85%) and Guyana (84%). Lower levels are observed in Honduras (70%), and particularly in El Salvador (61%) and Peru (59%). In the case of Peru, this is by design, as their integrated care model encourages care resolution in the familiar and community setting with supervising support of the primary level. Differences between rural and urban areas are generally modest in the countries with available data, although rural levels are slightly higher in some cases such as Guyana and El Salvador (Figure 5.10). It is important to stress the relevance of rational antibiotic use, both due to the health implications of antimicrobial resistance development and as a source of waste in health systems (OECD/The World Bank, 2020[2]).
