Program evaluation of an ORS and zinc scale-up program in 8 Nigerian states

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Felix Lam1, Ahmad Abdulwahab2, Jason Houdek2

  • 1Clinton Health Access Initiative, Boston, Massachusetts, USA.

Journal of Global Health
|May 11, 2019
PubMed

Insights

A program in Nigeria significantly increased the use of oral rehydration solution (ORS) and zinc for treating childhood diarrhea. This intervention improved treatment rates in both public and private healthcare sectors, saving young lives.

Area of Science:

  • Public Health Interventions
  • Pediatric Diarrheal Disease Management
  • Health Systems Strengthening

Background:

  • Diarrhea is a leading cause of mortality in Nigerian children under five.
  • A multi-state program (2012-2017) by CHAI and the Nigerian Government targeted increased treatment with oral rehydration solution (ORS) and zinc.
  • Interventions addressed demand, supply, and policy barriers across public and private sectors.

Purpose of the Study:

  • To evaluate the impact of a comprehensive program on ORS and zinc treatment for childhood diarrhea in Nigeria.
  • To assess changes in treatment rates and identify factors influencing ORS and zinc uptake.

Main Methods:

  • Cross-sectional household surveys were conducted at baseline, midline, and endline in program states.
  • Logistic regression models with generalized estimating equations were used to analyze changes in treatment practices.
  • The study assessed treatment variations based on healthcare sector (public vs. private).

Main Results:

  • Treatment with ORS increased from 38% at baseline to 55% at endline; combined ORS and zinc increased from 4% to 30%.
  • The odds of receiving ORS treatment were 1.88 times higher at endline; odds of receiving ORS and zinc combined were 15.14 times higher.
  • Significant improvements in ORS treatment probability were observed in both public (57% to 83%) and private (41% to 58%) sectors.

Conclusions:

  • The implemented program led to a significant increase in the use of ORS and combined ORS and zinc for diarrhea treatment.
  • The findings demonstrate the effectiveness of multi-faceted interventions in improving pediatric diarrheal disease management.
Abstract

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