ArticleJournal of global health2015
Scaling-up public sector childhood diarrhea management program: Lessons from Indian states of Gujarat, Uttar Pradesh and Bihar.
Article in Journal of global health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Barriers and facilitators to implementation of oral rehydration therapy in low- and middle-income countries: A systematic review.PloS one · 2021Pooled it
- Taking stock of 10 years of published research on the ASHA programme: examining India's national community health worker programme from a health systems perspective.Health research policy and systems · 2019Pooled it
- Prevalence and Treatment of Diarrhea Among Children in India, 2016-2021.JAMA network open · 2025Article
- Health programme spillover effects on childhood vaccination in India: a difference-in-differences analysis of the Zinc and Oral Rehydration Salts Programme using retrospective demographic health surveys data.BMJ public health · 2025Article
- Sustainability of zinc coverage for acute childhood diarrhea in Bangladesh and other low- and middle-income countries: one decade following the SUZY project.PLOS global public health · 2025Article
- Identifying spatial clustering of diarrhoea among children under 5 years across 707 districts in India: a cross sectional study.BMC pediatrics · 2023Article
- Increasing coverage of pediatric diarrhea treatment in high-burden countries.Journal of global health · 2019Article
- Effect of enhanced detailing and mass media on community use of oral rehydration salts and zinc during a scale-up program in Gujarat and Uttar Pradesh.Journal of global health · 2019Article
- LiST modelling with monitoring data to estimate impact on child mortality of an ORS and zinc programme with public sector providers in Bihar, India.BMC public health · 2018Article
- An external evaluation of the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program in Gujarat and Uttar Pradesh, India.Journal of global health · 2015Article
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Authors and funding
3 authors.
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Abstract
backgroundDiarrhea remains a leading cause of death among children under five in India. Public health sector is an important source for diarrhea treatment with oral rehydration salts (ORS) and zinc. In 2010, Micronutrient Initiative started a project to improve service delivery for childhood diarrhea management through public health sector in Gujarat, Uttar Pradesh (UP) and Bihar. This paper aims to highlight feasible strategies, experiences and lessons learned from scaling-up zinc and ORS for childhood diarrhea management in the public sector in three Indian states.
methodsThe project was implemented in six districts of Gujarat, 12 districts of UP and 15 districts of Bihar, which includes 10.5 million children. Program strategies included capacity building of health care providers, expanding service delivery through community health workers (CHWs), providing supportive supervision to CHWs, ensuring supplies and conducting monitoring and evaluation. The lessons described in this paper are based on program data, government documents and studies that were used to generate evidence and inform program scale-up.
results140 000 health personnel, including CHWs, were trained in childhood diarrhea management. During three years, CHWs had sustained knowledge and have treated and reported more than three million children aged 2-59 months having diarrhea, of which 84% were treated with both zinc and ORS. The successful strategies were scaled-up.
conclusionIt is feasible and viable to introduce and scale-up zinc and ORS for childhood diarrhea treatment through public sector. Community-based service delivery, timely and adequate supplies, trained staff and pro-active engagement with government were essential for program success.
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