Conduct a review of the state of the evidence for interventions that respond to acute watery diarrhoea (AWD), with a focus on Ethiopia.
This rapid review has found that there are many gaps in the evidence on humanitarian responses to acute watery diarrhoea (AWD) in Ethiopia, specifically in terms of necessary cross district and/or cross border co-ordination, as well as the human and financial resources needed for such aid (Fisseha, 2016; Oxfam GB, 2017; UNICEF, 2017a; OCHA Somalia, 2018). This is important in multi-sectorial aid programmes – which the majority of humanitarian responses are reported to be.
Infections such as AWD are public health concerns, especially in emergency settings where they can be spread quickly unless an outbreak is halted. Hence the need for rapid and accurate reporting of cases. The US Department of State Humanitarian Information Unit (HIU, 2017) reported 43,015 AWD/cholera cases in the Horn of Africa. The electronic Disease Early Warning Surveillance (eDEWS) system, supported by WHO, allows suspected cholera and AWD cases to be reported (OCHA Yemen, 2018). Government reports state that Federal Ministry of Health (FMoH) water, sanitation and hygiene (WASH) clusters also strengthen community-based AWD surveillance to detect new cases for timely response (Government of Ethiopia/OCHA, 2017).
However, it is not always stated who reports AWD cases: according to the WHO, rumours of
AWD/cholera outbreaks in certain areas can also be helpful to responses in disease situations (WHO Ethiopia, 2017a). The United Nations Children’s Fund (UNICEF) report that their Communications for Development (C4D) interventions focus on preventing the resurgence of AWD and integrate nutrition related messages in sites for internally displaced people (IDP) (UNICEF, 2017a).
Examples of interventions from neighbouring countries show that community-centred campaigns are also successful in stopping AWD outbreaks, e.g. in Bangladesh (UNICEF, 2017b). Since July 2016, volunteers from UNICEF and the Ethiopian Red Cross Society have been conducting mass public awareness campaigns using audio trucks deployed in each of the 10 sub-cities of Addis Ababa (Kiros, 2016). Response Plans focussing on both prevention and treatment (UNICEF, 2017b), such as the World Health Organisation Ethiopia (2017a) ‘1-to-5 network’, successfully advise families and individuals on how to protect themselves and seek treatment. Such Plans are implemented by woreda (district) and zonal administrators, and organised into seven pillars, namely: coordination team; surveillance; case management; social mobilisation; regulatory; logistics, and WASH interventions (Fisseha, 2016).
