title: The role of private providers in treating child diarrhoea in Latin America.
abstract: Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries - where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001). However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. hwaters@jhsph.edu
authors.forename: Hugh R
authors.initials: HR
authors.lastname: Waters
authors.forename: Laurel E
authors.initials: LE
authors.lastname: Hatt
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
mesh_terms: D001639:Bicarbonates / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D003967:Diarrhea / Q000628:therapy*; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America; D008297:Male; D011189:Potassium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D017149:Private Sector; D017150:Public Sector; D012959:Socioeconomic Factors; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D001639:Bicarbonates; C044142:World Health Organization oral rehydration solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D005947:Glucose