Tools for Measuring New Diarrhea Treatment Practices-Zinc

In 2004, UNICEF and WHO issued new recommendations for the treatment of pediatric diarrhea with continued use of oral rehydration salts (ORS) and administration of ten daily doses of zinc sulfate. While many Ministries of Health have accepted this recommendation in principal, few have had the commitment or the resources to introduce this protocol or to measure program impact. USAID's Social Marketing Plus for Diarrhea Disease Control (POUZN) Project developed an evaluation toolkit of complementary quantitative and qualitative tools that have been developed, field tested, refined and published, including: - Household survey questionnaires on diarrhea treatment; - Focus group discussion guides for caretakers, community-based distributors, and community health educators; - In-depth interview guides for program managers, public and private health facility staff, pharmacists, and drug sellers; - Mystery client surveys for private pharmacies, government facilities, and community-based agents.

The toolkit was implemented and refined in Nepal, and is being used to collect data and information on the zinc programs in Benin and Madagascar. Program results demonstrated the importance of communication and interaction with providers in assuring program success—factors now transferred to new programs. The richest program results data are acquired when an array of research tools is used to examine the program from different perspectives and to probe for behavioral antecedents and cultural nuances along with collecting quantitative survey data. This toolkit will be used in additional countries to assess motivators of correct use of ORS and zinc and to improve program implementation.