Working through Community-based Channels to Introduce Zinc for Treatment of Pediatric Diarrheas

Purpose: Diarrhea causes over 1.2 million child deaths annually. A combined commercial/community approach was used in Benin and Madagascar to improve diarrhea case management with zinc. Key community-based NGOs and/or women's action groups were engaged to increase awareness and access among caregivers and encourage correct use.

Data/Methods: Population-based household surveys of caregivers of children under five were conducted in Benin (n=2912) and Madagascar (n=1200). Each country survey used a multistage sampling design and weighted analysis. Interviewers administered structured questionnaires to caregivers.

Results: Friends, relatives, or community health workers were primary sources of treatment or advice in Benin (58%) and Madagascar (31%). In Benin, rural caregivers were more likely to first seek treatment or advice from friends or relatives (58%) or community workers (16%). Rural zinc users were more likely to obtain zinc from community workers, friends or relatives than urban zinc users (20% and 5%, respectively). The most common sources of zinc information were, after health personnel, friends and relatives (31%) and community workers/animators (28%). In Madagascar, friends, relatives and community workers were the second most common zinc information source (27%) after cinemobiles (31%); community workers were the second most common source of zinc (26%).

Implications: Community resources are highly sought for diarrhea advice and treatment. Assuring that program strategy includes interpersonal channels of communication in Africa is essential to improving home diarrhea treatment. Community distribution channels provide needed access to products. Partnerships with community organizations can both increase awareness and encourage correct zinc and ORS use.