Child Health

Treatment for Diarrhea

Caregivers appropriately provide treatment for diarrhea at onset of symptoms in children

Timely and appropriate treatment for diarrhea can prevent 93% of deaths due to diarrhea among children. 1The effect of oral rehydration solution and recommended home fluids on diarrhea mortality
Munos M, Fischer-Walker C.L., Black R.E.
2010
This is an occasional behavior that needs to be practiced without hesitation at the onset of diarrhea.

Key Points from Global Research

  • Expanding the number of well-trained, stocked and sanctioned private-sector providers selling diarrhea treatments can encourage caregivers to properly treat diarrhea.
  • Packaging or selling oral rehydration salts (ORS) and zinc together can ensure caregivers obtain what they need and provide the proper, continual treatment for diarrhea.
  • Assuring fixed, proper pricing of both ORS and zinc can encourage caregivers to use it properly and when needed.

Behavior Profile Sample: Treatment for Diarrhea

A Behavior Profile is a summary analysis of each behavior. This sample draws from global evidence and illustrates the result of using the Create Behavior Profiles Tool to analyze factors, supporting actors and strategies and to ensure logical pathways exist between strategies proposed and factors related to the practice of the behavior. This sample may be used as a starting point or reference for creating country-specific Behavior Profiles.

CREATE Country-specific Behavior Profiles

Improve maternal and child survival
Caregivers appropriately provide treatment for diarrhea at onset of symptoms in children
Percentage of children born in the five years preceding the survey with diarrhea in the two weeks preceding the survey who received oral rehydration solution (ORS), that is either fluid from an ORS packet or a pre-packaged ORS fluid

Behavior Analysis

Strategy

STEPS

What steps are needed to practice this behavior?
  1. Recognize signs and symptoms of diarrhea
  2. Obtain ORS and full course of zinc from a sanctioned source
  3. Give child ORS throughout the diarrheal episode
  4. Give child a daily zinc supplement (usually for 10 to 14 days)
  5. Continue or increase breastfeeding appropriate for age
  6. Continue other fluids and feeding as possible during illness
  7. Provide extra food according to age for at least 2 weeks following illness

Click on any box
        to see the pathwaysA pathway illustrates how elements in the Behavior Profile are linked. When read from right to left, a pathway highlights how strategies are expected to address the factors to enable adoption of the Accelerator Behavior.  
        of the behavior.

FACTORS

What factors may prevent or support practice of this behavior? These should be analyzed for each country context.
Structural
Accessibility: ORS and zinc are not always readily available beyond the health system
Provider Competencies: Providers tend to over-prescribe antibiotics
Facility Experience: Caregivers often prefer to frequent nearby and informal sector sources for treatment of diarrhea
Social
Norms: Diarrhea is considered common and expected for young children; immediate careseeking is not widely supported
Internal
Attitudes and Beliefs : Caregivers are not convinced ORS and zinc are effective, they prefer antibiotics
Skills: Most caregivers do not follow the full 10-day zinc regime because they do not understand the instructions
Knowledge: Most caregivers are unaware of the need for special recuperative feeding after illness

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior?
Institutional
Policymakers: Begin dialogue to ensure private sector is engaged and sanctioned
Providers: Prescribe ORS/Zinc instead of antibiotics for diarrhea and explain benefit to caregivers
Community
Community Leaders: Promote immediate care-seeking for all sick children

POSSIBLE PROGRAM STRATEGIES

How might we focus our efforts based on this analysis?
Enabling Environment
Financing: Expand free or low-cost access to ORS and zinc
Partnerships and Networks: Engage the private sector in recommending and distribution of ORS and zinc at local pharmacies
Systems, Products and Services
Products and Technology: Combine ORS and zinc packets in grocery stores, pharmacies, kiosks, etc.
Quality Improvement: Ensure health care personnel (public and private) practice appropriate antibiotic prescription vs use of ORS and zinc and train them on how to communicate that to caregivers
Demand and Use
Communication: Provide pictorial instructions for mixing and administering ORS and daily reminders for zinc supplements
Collective Engagement: Conduct ongoing community activities about the dangers of dehydration resulting from diarrhea, the need for immediate careseeking, effectiveness of ORS and zinc, and the need for recuperative feeding after illness

Global Status of Accelerator Behavior

Percentage of children born in the five years preceding the survey with diarrhea in the two weeks preceding the survey who received oral rehydration solution (ORS), that is either fluid from an ORS packet or a pre-packaged ORS fluid

Demographic and Health Survey, Rapid Survey on Children, The DHS Program Indicator Data API, The Demographic and Health Surveys (DHS) Program, UNICEF Multiple Indicator Cluster Surveys

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