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Commentary: child health surveys: the equity dimension.

Larson and colleagues make an important contribution to the literature on inequities in child health in Asia by providing evidence of marked gender and socioeconomic bias in diarrhoea management in Bangladesh. Their findings speak for themselves. Oral rehydration (ORS) a low-cost intervention that could prevent ~13% of all under-five deaths in the world was significantly more likely to be administered to boys than to girls and to the least poor than to the poorest. Antibiotics that are only indicated in a small proportion of diarrhoea episodes but are nevertheless widely used were also more likely to be used by boys and by the least poor. This commentary will concentrate on the issue of social inequities rather than on the deplorable preference for treating male children. These findings must be interpreted in light of the marked progress Bangladesh has achieved in terms of child survival in recent years. Under-five mortality dropped from 149 in 1990 to 77 in 2004. The country is currently one of seven-among the 60 countries with the highest burden of under-five deaths-to be on target for reaching the corresponding Millennium Development Goal. Nevertheless as shown by Larson et al. and Bryce et al. a large proportion of Bangladeshi children who have diarrhoea still fail to receive ORS. Scaling up the use of this simple solution can make a major contribution to the further reduction of mortality levels at low cost. (excerpt)