Project Lead(s): Marion Roche
With 2.5 billion cases per year, diarrhea affects more children than any other childhood illness.
Oral Rehydration Therapy (ORT) for the treatment of diarrhea has been recommended for two decades, yet deaths still occur.
Implemented in Guatemala, the project aimed to:
1. Co-package the oral rehydration solution (ORS) with zinc to positively change provider and caregiver behaviour in diarrhea treatment in Guatemala and improve diarrhea treatment adherence
2. Provide the government with a cost-benefit analysis of the feasibility and acceptability of co-packaging ORS and zinc
3. Demonstrate that co-packaging could be developed that would be attractive to mothers, and improve adherence by providing them with a reminder for use and instructions on use
4. Show that facility-level co-packaging could influence positive provider and caregiver behaviour
5. Assess co-packaging zinc with pneumonia antibiotic treatment.
The randomized community trial lasted about two months, during which 188 cases of diarrhea and 72 pneumonia cases were detected and included in the study.
Results from this study showed that this model of co-packaging increases distribution of ORS and zinc, and enhances adherence to diarrhea treatment in children.
Caregivers receiving the treatment in the co-pack were 1.66 times more likely to give their child the full dose of zinc, and intervention health post staff were 40% less likely to give antibiotics in addition to ORS and zinc – a practice the Ministry of Health has been trying to discourage.
Researchers found that there was a strong preference for the zinc co-pack, with 88% of caregivers saying they preferred it to separate loose products because it kept the medicine clean, reminded them how much to give and was attractive.
Caregivers perceived the co-packaged ORS and zinc had greater value than ORS and zinc given separately.
This work was disseminated through conferences and events.
There are also many blogs on the project in the Huffington Post, such as this example.
Communication and amplification of findings has created momentum around, and supported interest in, co-packaging as an approach for diarrheal treatment; the Inter-American Development Bank and the United Nations Essential Commodities Pneumonia & Diarrhea Demand Generation Working Group are both keen to learn from the results of the project.