Limits...
Public sector scale-up of zinc and ORS improves coverage in selected districts in Bihar, India.

Walker CL, Taneja S, Lamberti LM, Black RE, Mazumder S - J Glob Health (2015)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Survey profiles for both baseline and endline household surveys. mo – months.
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Figure 2: Survey profiles for both baseline and endline household surveys. mo – months.

Mentions: We screened 2645 and 5843 caregivers with a child 2–59 months of age in the baseline and endline, respectively (Figure 2). We asked the caregiver questions about the youngest child in this age group and found the mean age of the child to be similar in the baseline (24.5 months) and endline (24.6 months) surveys. Fifty–four percent were boys in both surveys. Two–week prevalence of diarrhea was lower at the endline survey than at baseline (16.5% at baseline vs 12.8% at endline, P < 0.05); it should be noted that the surveys were conducted at different times of year and thus change cannot be attributed to the program. The mean age of the caregiver was 26.8 (standard deviation, SD: 5.1) years at baseline and 27.3 (SD: 5.2) years at endline, and more than 60% of mothers in both surveys had never attended school. More than half of the households included in the survey possessed a below poverty line (BPL) card and more than 80% of households had no access to an improved sanitation facility (ie, toilet or latrine). Additional household characteristics are presented in Table 1.


Public sector scale-up of zinc and ORS improves coverage in selected districts in Bihar, India.

Walker CL, Taneja S, Lamberti LM, Black RE, Mazumder S - J Glob Health (2015)

Survey profiles for both baseline and endline household surveys. mo – months.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544234&req=5

Figure 2: Survey profiles for both baseline and endline household surveys. mo – months.
Mentions: We screened 2645 and 5843 caregivers with a child 2–59 months of age in the baseline and endline, respectively (Figure 2). We asked the caregiver questions about the youngest child in this age group and found the mean age of the child to be similar in the baseline (24.5 months) and endline (24.6 months) surveys. Fifty–four percent were boys in both surveys. Two–week prevalence of diarrhea was lower at the endline survey than at baseline (16.5% at baseline vs 12.8% at endline, P < 0.05); it should be noted that the surveys were conducted at different times of year and thus change cannot be attributed to the program. The mean age of the caregiver was 26.8 (standard deviation, SD: 5.1) years at baseline and 27.3 (SD: 5.2) years at endline, and more than 60% of mothers in both surveys had never attended school. More than half of the households included in the survey possessed a below poverty line (BPL) card and more than 80% of households had no access to an improved sanitation facility (ie, toilet or latrine). Additional household characteristics are presented in Table 1.

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus