TY - JOUR
T1 - Public sector scale-up of zinc and ORS improves coverage in selected districts in Bihar, India
AU - Walker, Christa L.Fischer
AU - Taneja, Sunita
AU - Lamberti, Laura M.
AU - Black, Robert E.
AU - Mazumder, Sarmila
N1 - Funding Information:
The authors would like to thank the caregivers who participated in the survey. The authors thank partners at the Micronutrient Initiative for their feedback with regard to interpretation of the final results. This work was supported by a grant from the Children's Investment Fund Foundation. The funder played no role in the analysis or final interpretation and presentation of the data. Funding: This work was supported by a grant from The Children's Investment Fund Foundation (CIFF) (UK).
Funding Information:
We received ethical approval from the Johns Hopkins University Bloomberg School of Public Health Institutional Review Board and the Society for Applied Studies Ethics Review Committee in New Delhi, India.
PY - 2015
Y1 - 2015
N2 - Background In Bihar, India, a new initiative to enhance diarrhea treatment with zinc and ORS in the public sector was rolled out in selected districts. We conducted an external evaluation to measure changes in diarrhea careseeking and treatment in intervention districts. Methods We conducted baseline and endline household surveys among caregivers of children 2-59 months of age. We calculated summary statistics for household characteristics, knowledge, careseeking and treatments given to children with a diarrhea episode in the last 14 days and built logistic regression models to compare baseline and endline values. Results Caregivers named a public health center as an appropriate source of care for childhood diarrhea more often at endline (71.3%) compared to baseline (38.4%) but did not report increased careseeking to public sector providers for the current diarrhea episode. In logistic regression analyses, the odds of receiving zinc, with or without oral rehydration salts (ORS), increased at endline by more than 2.7 as compared to baseline. Children who were taken to the public sector for care were more likely to receive zinc (odds ratio, OR = 3.93) and zinc in addition to ORS (OR = 6.10) compared to children who were not taken to the public sector. Conclusion Coverage of zinc and ORS can improve with public sector programs targeted at training and increasing product availability, but demand creation may be needed to increase public sector careseeking in areas where the private sector has historically provided much of the care.
AB - Background In Bihar, India, a new initiative to enhance diarrhea treatment with zinc and ORS in the public sector was rolled out in selected districts. We conducted an external evaluation to measure changes in diarrhea careseeking and treatment in intervention districts. Methods We conducted baseline and endline household surveys among caregivers of children 2-59 months of age. We calculated summary statistics for household characteristics, knowledge, careseeking and treatments given to children with a diarrhea episode in the last 14 days and built logistic regression models to compare baseline and endline values. Results Caregivers named a public health center as an appropriate source of care for childhood diarrhea more often at endline (71.3%) compared to baseline (38.4%) but did not report increased careseeking to public sector providers for the current diarrhea episode. In logistic regression analyses, the odds of receiving zinc, with or without oral rehydration salts (ORS), increased at endline by more than 2.7 as compared to baseline. Children who were taken to the public sector for care were more likely to receive zinc (odds ratio, OR = 3.93) and zinc in addition to ORS (OR = 6.10) compared to children who were not taken to the public sector. Conclusion Coverage of zinc and ORS can improve with public sector programs targeted at training and increasing product availability, but demand creation may be needed to increase public sector careseeking in areas where the private sector has historically provided much of the care.
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U2 - 10.7189/jogh.05.020408
DO - 10.7189/jogh.05.020408
M3 - Article
C2 - 26322230
AN - SCOPUS:85025148454
SN - 2047-2978
VL - 5
JO - Journal of global health
JF - Journal of global health
IS - 2
M1 - 020408
ER -