Hello everyone
I have been following this thread with great interest given my work to improve access to co-packaged ORS and Zinc for the treatment of childhood diarrhoea and getting co-packaged ORS and Zinc listed in the WHO Essential Medicines List (from 2019). We can discuss the relative importance of access to treatment, awareness among caregivers and so on. What my experience tells me is that the availability of a desirable product to treat diarrhoea is catalytic. It generates interest and so helps with all the other factors. It incentivises health workers to impart knowledge on how to treat diarrhoea if they can point to a product that enables caregivers to use their newly acquired knowledge. It also stimulates enquiry from caregivers - "What's that you're using?" - which helps spread knowledge and awareness.
So, how do you create a "desirable" treatment for diarrhoea? The answer is that you ask caregivers about diarrhoea and the issues they face treating it in the home and then you design a product that overcomes these challenges. The top three are likely to be ORS sachet size (1 L sachets are too big for home treatment), ORS taste and the infrequency with which they are given Zinc.
If anyone would like dig into this further into this, please see: Design thinking to improve rational use of oral rehydration salts: lessons from an innovative co-packaged diarrhoea treatment kit https://innovations.bmj.com/content/9/3/132 (I'm a co-author).
This work received development assistance until 2018 but has scaled further since then through local manufacture and distribution through both the private and public sectors. It will have contributed to the increase in ORS/Zinc coverage rate in Zambia from <1% (2012) to 38% (DHS 2024).
CHIFA profile:
Simon Berry has worked to increase access to ORS and Zinc for the treatment of diarrhoea in children. He co-founded ColaLife and the ORS/Zinc Co-pack Alliance (ORSZCA). In 2023 he was awarded an OBE for services to global child health. Professional interests: System change for better child health, Institutionalising innovation, ORS/Zinc. sxberry AT gmail.com