Oral rehydration therapy: combining anthropological and epidemiological approaches in the evaluation of a Papua New Guinea programme.

The impact of an oral rehydration therapy (ORT) programme for diarrhoeal disease was evaluated by means of continuing surveillance of this Papua New Guinea population. Mortality from diarrhoeal disease in the under-fives fell from 3.3/1000/annum before the ORT programme to 1.3/1000/annum after the programme had become established. However there is evidence that the attendance rate for diarrhoea treatment has begun to fall from its previously high level. These trends are explicable in terms of the target population's expectations of Western treatments. The implications of these findings for the design and evaluation of similar health programmes are discussed.