Engaging Rural Medical Providers in Improved Diarrhea Management in Uttar Pradesh (UP) India

USAID's POUZN Project was created to promote the use of point-of-use (POU) water disinfection and zinc treatment for diarrhea in India and other countries. Anecdotal evidence reveals that more than three-quarters of rural Indian households seek health treatment from unlicensed rural medical practitioners (RMPs). Yet, neither the public sector, nor the zinc manufacturers reached the RMPs. POUZN baseline data showed 0% knowledge of zinc treatment among rural medical practitioners and no drugstores carrying zinc treatment in rural district. POUZN partnered with the zinc manufacturers and local NGOs to recruit and train health promoters from the rural community to promote the rational treatment of diarrhea to RMPs. Appropriate promotion material was developed, including a short video to standardize the information provided to RMPs. After a short three-month project 28% (391 of 1547) of RMPs prescribed zinc treatment and 52% of drugstores (267 of 518) stocked zinc treatment. The project conducted pre- and post-implementation surveys of RMPs and chemists to determine product availability and prescriptions. On-going monitoring continues on behavior change. The project is now going to scale partnering with multiple NGOs to target more than 28,800 RMPs and all chemists in 144 blocks of twelve UP districts. This expansion program is scheduled to end by September, 2009. Early results confirm the rapid adoption rate by RMPs. The program created scalable demonstration models to improve zinc's penetration; and created sustainable partnerships among the private sector and NGOs. Finally, the presentation will discuss how this approach can be applied in other environments.