In a study aimed to estimate the effect of activities on ORS and zinc use, a scale-up program was executed from 2012-2016 by The Clinton Health Access Initiative to upsurge the use of oral rehydration salts (ORS) and zinc to treat diarrhea in children under 5 in three states: Madhya Pradesh, Gujarat, and Uttar Pradesh. The program comprised development and detailing of a rural supply chain to reach private rural health care providers, training of Accredited Social Health Activists (ASHAs), technical support to the state governments, and a mass media campaign targeted at caregivers. In Gujarat and Uttar Pradesh, program activities, like detailing and ASHA trainings, were targeted to high-burden focal districts, consequently providing an opportunity to study their outcomes compared to state-wide activities that sheltered all districts.

Household assessments were piloted at two points throughout the program and in both pivotal and non-pivotal districts. A difference-in-difference quasi-experimental tactic was used to evaluate the effect of the improved activities in focal districts and mass media campaign on the probabilities of a child being treated with ORS and zinc.

Pivotal district interventions were related with a noteworthy increase in the odds of a diarrhea episode getting ORS in Gujarat and Uttar Pradesh. Living in pivotal districts enlarged the odds of receiving ORS in both states by factors of 3.42 (95% CI = 1.39-8.33) and 2.29 (95% CI = 1.19-4.39), individually. Pivotal district involvements were also associated with 15.02 (95% CI = 2.97-75.19) superior odds of receiving both ORS and zinc in Gujarat. In Uttar Pradesh (where the mass media operation was focused), exposure to the campaign additionally changed the odds of receiving ORS and combined ORS and zinc by 1.38 (95% CI = 1.04-1.84) and 1.57 (95% CI = 1.01-2.46), respectively.

Conclusion: Wide-ranging public and private provider involvements combined with mass media are effective approaches for growing ORS and zinc use.

Source: J Glob Health. 2019 Jun;9(1):010501.