CDD [control of diarrheal diseases] and ARI [acute respiratory infection] programs in sub-Saharan Africa : redefining their roles in a changing context = Programmes de LMD [lutte contre les maladies diarrheiques] et IRA [infections respiratoires aigues] en Afrique subsaharienne : redefinir leurs roles dans un contexte changeant

In the 1980s, national CDD programs made tremendous progress in preventing childhood deaths from diarrhea-induced dehydration. However, as governments" commitment to and external funding for CDD have waned, so have performance indicators, and it appears that use of oral rehydration therapy (ORT) has begun to decline. ARI programs began later and have not yet made much progress. While many governments have devised action plans for national ARI programs, lack of funding has prevented their implementation; little training or health education has been conducted. National governments and donors should move quickly to correct their neglect of these programs by promoting integrated health care, a decentralized delivery system, and strengthened African technical leadership and institutions. Integrated case management protocols can address the leading causes of child mortality, but their sustainability depends on ongoing support, supplies, and supervision. Behavior change is a lengthy process for both health workers and family caregivers, requiring continued attention beyond initial training and health education campaigns.