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Reducing the burden of diarrhea among children under five years old: lessons learned from oral rehydration therapy
Zulfiya Charyeva1, Molly Cannon2, Olugbenga Oguntunde3
1Futures Group, 401 Meadowmont Village Circle, Chapel Hill, NC, 27517, USA. zcharyeva@futuresgroup.com.
Insights
Oral Rehydration Therapy (ORT) corners in Nigeria improved caregiver knowledge and skills for childhood diarrhea management. However, consistent supply chains and improved protocols are crucial for optimal service delivery and preventing stockouts.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Diarrhea is a leading cause of mortality in Nigerian children under five.
- Oral Rehydration Therapy (ORT) corners were established in Bauchi and Sokoto states to treat childhood diarrhea and educate caregivers.
- These corners aimed to improve diarrhea case management and prevention skills among caregivers.
Purpose of the Study:
- To evaluate the impact of facility-based ORT corners on caregivers' knowledge and skills in managing childhood diarrhea.
- To identify facilitators and barriers to ORT corner service utilization and delivery from caregiver and provider perspectives.
- To assess adherence to established protocols in ORT corner activities.
Main Methods:
- A quantitative operations research study utilizing surveys with ORT corner providers (N=21), health facility providers (N=23), and caregivers (N=229).
- Included a review of service statistics and health facility observations to provide a comprehensive assessment.
- Data analysis involved frequency distribution and binary analysis.
Main Results:
- Caregivers utilizing ORT corners demonstrated significantly higher knowledge in diarrhea prevention and management compared to non-users.
- Despite improvements, the overall percentage of knowledgeable ORT users was suboptimal, indicating a need for continued provider education.
- Key barriers identified by providers included lack of essential supplies, inadequate information, education, and communication materials, and insufficient supportive supervision and documented protocols.
Conclusions:
- Ensuring consistent stock of oral rehydration salt (ORS) packages and zinc supplements is critical for ORT corner functionality.
- Establishing a secure commodity supply chain is essential to prevent stockouts and ensure service continuity.
- Implementing adequate policies, procedures, and supportive supervision is necessary for effective ORT corner program implementation.
Background:
In Nigeria, diarrhea remains one of the leading causes of death among children under five years old. Oral Rehydration Therapy (ORT) corners were introduced to health facilities in Bauchi and Sokoto states to serve as points of treatment for sick children and equip caregivers with necessary skills in case management of diarrhea and diarrhea prevention.
Objectives:
The operations research study examined the effect of facility-based ORT corners on caregivers' knowledge and skills in management of simple and moderate diarrhea at home, as well as caregivers' and service providers' perceived facilitators and barriers to utilization and delivering of ORT corner services. It also examined whether ORT activities were conducted according to the established protocols.
Methods:
This quantitative study relied on multiple sources of information to provide a complete picture of the current status of ORT corner services, namely surveys with ORT corner providers (N = 21), health facility providers (N = 23) and caregivers (N = 229), as well as a review of service statistics and health facility observations. Frequency distribution and binary analysis were conducted.
Results:
The study revealed that ORT corner users were more knowledgeable in diarrhea prevention and management and demonstrated better skills for managing diarrhea at home than ORT corner non-users. However, the percentage of knowledgeable ORT users is not optimal, and providers need to continue to work toward improving such knowledge. ORT corner providers identified a lack of supplies as the major barrier for providing services. Furthermore, the study revealed a lack of information, education and communication materials, supportive supervision, and protocols and guidelines for delivering ORT corner services, as well as inadequate documentation of services provided at ORT corners.
Recommendations:
Recommendations for ORT corners program planners and implementers include ensuring all ORT corners have oral rehydration salt (ORS) packages and salt, sugar, and zinc tablets in stock, a secured commodity supply chain to avoid stockouts, and adequate policies and procedures in place.
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