01 Dec 2015

Baseline cross sectional survey report

CIFF

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

  • Region

    South Asia

  • Topic

    Nutrition

  • Priority area

    Child Health & Development

  • EVALUATEE ORGANISATION

    Johns Hopkins Bloomberg School of Public Health

  • Report Type

    Evaluations and partner reports

Download pdf

[taken from document introduction]

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.