Kerala led from the front to contain the incidence of diarrhoeal diseases — the second largest killer of children below five in rural areas — largely due to women’s education and breastfeeding, said an expert here on Tuesday.

“Kerala and other south Indian states pip their counterparts in the North in preventing this disease. Social development is high in these states,” said Nirmal Kumar Ganguly, President, Asian Conference on Diarrhoeal Disease and Nutrition (ASCODD).

“And if a child is given breastfeeding at least for six months, the child is largely protected.”

He was speaking at the 14th ASCODD meet, supported by the Bill & Melinda Gates Foundation. The theme this year is “Saving lives: innovations and solutions for diarrhoeal diseases, enteric fever and malnutrition”.

Ganguly explained that lack of girls’ education, malnutrition, paucity of latrines and gender imbalance are some reasons why states like Rajasthan, Uttar Pradesh, Odisha and Madhya Pradesh are struggling to ward off diarrhoeal diseases.

He suggested WASH (water, sanitation and hygiene), balanced nutrition and vaccines such as rotavirus, typhoid vaccine and cholera vaccine as preventive measures for diarrhoeal diseases.

“WASH can be connected to Swachh Bharat Mission, and other preventive activities could be linked to the National Health Mission, which moves to the lowest level of the healthcare,” he added.

He pointed out that the disease is a hindrance to the growth of nation as one of the outcomes of diarrhoea is stunted growth.

“If you have a stunted nation, its growth in every sphere is affected. So this is very much linked to the development of a nation,” the expert added.

About the biennial conference, Ganguly said that during the early 60s or 70s, diarrhoeal diseases were one of the largest killers of children below five.

“That was one of the major causes of morbidity in children up to adolescence, and for those who survived, it led to malnutrition and many children became stunted.

“Nutrition is the highest challenge still in India. Though the mortality rate of diarrhoea has come down in rural areas, it is still the second killer after pneumonia with regard to children below five,” he pointed out.