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An Intervention to Co‐package Zinc and Oral Rehydration Salts (ORS) Improves Health Provider Prescription and Maternal Adherence to WHO‐recommended Diarrhea Treatment in Western Guatemala
Author(s) -
Roche Marion,
García Meza Rosario,
Vossenaar Marieke
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.902.23
Subject(s) - medicine , medical prescription , diarrhea , intervention (counseling) , randomized controlled trial , family medicine , pediatrics , nursing
Background Diarrhea remains the second greatest cause of child morbidity and mortality in Guatemala, yet adherence to the WHO recommended treatment of Zinc (Zn) & ORS is low. Objective We evaluated the effectiveness of health‐facility‐level co‐packaging of Zn and ORS to improve health provider prescription practices and caregivers' adherence to the diarrhea treatment (2 days ORS; 10 days Zn) for children 2‐59 months of age in rural Guatemala. Methods Zn & ORS co‐packaging development was guided by social marketing and then evaluated in a community‐randomized intervention trial. The intervention group (IG) received Zn & ORS in a graphic co‐pack with instructions and provider messages for counseling in diarrhea treatment. The control group (CG) received normative care of Zn and ORS without co‐packaging or messages. Home‐monitoring of adherence was conducting at 5 and 10 days post‐prescription in 20 health posts in San Marcos, Province. Results Health providers in the IG were more likely to dispense both medications than those of the CG (aOR: 2.3; 95%CI: 1.0, 5.4). IG mothers (n=123) were more likely to give the full 10 days of zinc (aOR:1.7; 95%CI; 1.0, 2.8) than CG mothers (n=138), and IG mothers provided 1 more day of Zn (p<0.01). Conclusions The co‐packaging intervention improved both the prescription practices and adherence to zinc. This innovation could improve diarrhea treatment in Guatemala and holds potential utility in other situations of combined therapies. Research Support Grand Challenges Canada & Micronutrient Initiative