Encouraging Caregiver Use of Zinc and ORS for the Treatment of Pediatric Diarrheas

Abstract

Objectives: The use of zinc with oral rehydration solution (ORS) is a new diarrhea treatment protocol, introduced in 2004; relatively little data is available on caregiver behaviors. This abstract describes key caregiver knowledge, attitudes and practices related to use of zinc and ORS for the treatment of pediatric diarrheas gleaned from six country programs implemented over the past 8 years. Methods: USAID's POUZN and SHOPS projects conducted population-based household surveys in Nepal (n=3550), Pakistan (n=1713), Benin (n=3196), Uganda (n=800), Madagascar (n=1200) with caregivers of children under five with diarrhea.   Results: All countries had increased zinc use (ranging from 5% in Madagascar to 54% in Benin) over the project period. Although knowledge about zinc as a treatment was high (over 90% in most countries), correct use for the full 10 days and along with ORS fell short (ranging between 12% in Pakistan and 65% in Benin. Affordability, availability of zinc products and recall of zinc messaging were important drivers of use. In all countries there was a statistically significant association (p<.001) between exposure to a zinc message, either from media or a doctor, and use of zinc.  Zinc users were more likely to know where to obtain zinc, believe that they could find zinc near their home, and feel that the product was affordable, than non-users. Conclusions: Reliable research data on caregiver knowledge, attitudes and practices is critical to the process of identifying and addressing key motivators and barriers to trial and correct use of zinc and ORS for diarrhea management.