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Open Access Publications from the University of California

Preventable Deaths: Children, Diarrhea, and the Politics of Oral Rehydration Solution in Kenya

  • Author(s): Combes, Nathan John
  • Advisor(s): Ferree, Karen E
  • Gibson, Clark C
  • et al.

Every year in Kenya, more than 100,000 children under the age of five die. 90 percent of these deaths can be avoided via the administration of basic essential medicines. Diarrhea is one illness that is easily and cheaply treated, yet more than 5,400 Kenyan children die from it every year. Proper use of oral rehydration solution (ORS) prevents mortality in 93 percent of diarrheal cases, and the average daily dose costs only 15 US cents. Children are dying because they are not receiving this effective and affordable treatment. The main claim of this dissertation is that low uptake of ORS in Kenya is a problem of supply not demand. Contrary to previous scholarship, I will show that Kenyans demand ORS and administer it to their children when it is available. However, ORS is frequently out of stock in local dispensaries. Using data from an independent audit, I show that 40 percent of Ministry of Health dispensaries in western Kenya have zero ORS in stock. I offer suggestive evidence of what is causing this lack of supply: politicians in Kenya are more incentivized to provide highly visible projects rather than high-impact, low-cost solutions.

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