Online Program

Increasing use of zinc in the treatment of pediatric diarrhea in Benin: Lessons learned for global programs

Tuesday, November 5, 2013

Emily Sanders, MSc, International Health Division, Abt Associated Inc, Bethesda, MD
Kathryn Banke, PhD, International Health Division, Abt Associates, Denmark
Vicki MacDonald, M.A., MPH, International Health Division, Abt Associates, Bethesda, MD
Julie Williams, MPP, Social and Economic Policy, Abt Associates Inc, Bethesda, MD
Njara Rakotonirina, Population Services International, Benin
Treatment of uncomplicated pediatric diarrhea with 10-14 days of zinc sulfate plus oral rehydration solution (ORS) could avert over 20 percent of worldwide childhood deaths. OraselZinc, a diarrhea treatment kit (zinc plus ORS), was introduced in Benin in 2008 through private sector channels. Abt Associates and Population Services International conducted population-based surveys to assess caregivers' knowledge, attitudes, and practices related to pediatric diarrhea treatment both before and following implementation of several demand and supply-side interventions. A multi-stage sampling approach was used to select caregivers of children under 5 with diarrhea in the past 2 weeks in 28 communes in Benin in 2009 (n=307) and 2011 (n=392). Zinc use increased from 31% in 2009 to 54% in 2011 (p<0.01); however, use of antibiotics also increased both overall and among zinc users. Most zinc users in 2011 (62%) treated with zinc because a provider recommended it. Zinc use was significantly correlated with recall of generic diarrhea treatment and branded OraselZinc messages. TV was a major source of messages (76% in 2011). Logistic regressions showed that exposure to OraselZinc messages (p<0.05), speaking to someone about zinc (and specifically speaking to health personnel) (p<0.05), seeking treatment from a professional health provider (p<0.05), and ability to obtain OraselZinc kits nearby (p<0.05) were significantly associated with zinc use. Few programs in the world have achieved such high zinc use rates. To maximize success, future global zinc programs should combine demand generation, provider sensitization and addressing supply side barriers to impact caregiver and provider behavior.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Social and behavioral sciences

Learning Objectives:
Discuss changes in zinc and ORS use in Benin from 2009 to 2011 List factors significantly associated with zinc use in Benin in 2009 and 2011 Discuss lessons learned and implications for global zinc programs

Keyword(s): Child Health, Diarrhea

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work on the Child Health portfolio of the USAID SHOPS Project. I have been the research manager on this study including managing the work of the local data collection firm, reviewing and analyzing data, synthesizing the findings and authoring the final report, and coordinating the inputs of my co-authors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.