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

Caregiver knowledge of appropriate sources of care for diarrhea treatment at baseline and endline.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4544234&req=5

Figure 3: Caregiver knowledge of appropriate sources of care for diarrhea treatment at baseline and endline.

Mentions: We found that caregivers were overall better able to identify a variety of providers as sources of care for a child with diarrhea at endline (Figure 3). However, the largest increase in awareness was found for public sector sources. At baseline, 0.2% of caregivers named an AWW as an appropriate source of care and 1.1% named an ASHA, which to 10.4% and 11.9%, respectively in the endline survey. At endline we sought to understand more about the possible shift to public sector by asking each caregiver if she had ever sought care for diarrhea treatment from these community level workers; we found that 18.9% had sought care from an ASHA or AWW for childhood diarrhea. Primary health centers (PHCs) were mentioned as an appropriate source of care by 38.4% of caregivers at baseline and 71.3% at endline; private sector sources were the most widely identified in both surveys.


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)

Caregiver knowledge of appropriate sources of care for diarrhea treatment at baseline and endline.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Caregiver knowledge of appropriate sources of care for diarrhea treatment at baseline and endline.
Mentions: We found that caregivers were overall better able to identify a variety of providers as sources of care for a child with diarrhea at endline (Figure 3). However, the largest increase in awareness was found for public sector sources. At baseline, 0.2% of caregivers named an AWW as an appropriate source of care and 1.1% named an ASHA, which to 10.4% and 11.9%, respectively in the endline survey. At endline we sought to understand more about the possible shift to public sector by asking each caregiver if she had ever sought care for diarrhea treatment from these community level workers; we found that 18.9% had sought care from an ASHA or AWW for childhood diarrhea. Primary health centers (PHCs) were mentioned as an appropriate source of care by 38.4% of caregivers at baseline and 71.3% at endline; private sector sources were the most widely identified in both surveys.

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