ArticleJournal of global health2019
Program evaluation of an ORS and zinc scale-up program in 8 Nigerian states.
Article in Journal of global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Adherence to oral zinc supplementation in the management of acute diarrhoeal disease among under-5 children: A systematic review and meta-analysis.Epidemiology and infection · 2025Pooled it
- Barriers and facilitators to implementation of oral rehydration therapy in low- and middle-income countries: A systematic review.PloS one · 2021Pooled it
- The epidemiology of acute gastrointestinal illness in Ethiopia, Mozambique, Nigeria, and Tanzania: a population survey.Epidemiology and infection · 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
- Impact of co-packaging oral rehydration salts and zinc on diarrhoea treatment dispensing behaviour in selected rural health facilities in Zambia.PLOS global public health · 2025Article
- A situational assessment of treatments received for childhood diarrhea in the Federal Republic of Nigeria.PloS one · 2024Article
- Assessing the relationship of recommended diarrhea case management practices with the nutritional status of children aged between 0 to 59.9 months.Health open research · 2023Article
- Childhood Diarrhea Prevalence and Uptake of Oral Rehydration Solution and Zinc Treatment in Nigeria.Children (Basel, Switzerland) · 2022Article
- Article
- Childhood diarrhoea: a cross-sectional survey on maternal knowledge, hygienic practices and use of oral zinc for home management in a Nigerian community.The Pan African medical journal · 2022Article
- Private health care market shaping and changes in inequities in childhood diarrhoea treatment coverage: evidence from the analysis of baseline and endline surveys of an ORS and zinc scale-up program in Nigeria.International journal for equity in health · 2021Article
- Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17.The Lancet. Global health · 2020Article
- Progress in the use of ORS and zinc for the treatment of childhood diarrhea.Journal of global health · 2019Article
- An evaluation of a national oral rehydration solution and zinc scale-up program in Kenya between 2011 and 2016.Journal of global health · 2019Article
- Increasing coverage of pediatric diarrhea treatment in high-burden countries.Journal of global health · 2019Article
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Nigeria, diarrhea is the second leading killer of children under five. Between 2012-2017, the Clinton Health Access Initiative, Inc. (CHAI) and the Government of Nigeria implemented a comprehensive program in eight states aimed at increasing the percentage of children under five with diarrhea who were treated with zinc and oral rehydration solution (ORS). The program addressed demand, supply, and policy barriers to ORS and zinc uptake through interventions in both public and private sectors. The interventions included: (1) policy revision and partner coordination; (2) market shaping to improve availability of affordable, high-quality ORS and zinc; (3) provider training and mentoring; and (4) caregiver demand generation.
methodsWe conducted cross-sectional household surveys in program states at baseline, midline, and endline and constructed logistic regression models with generalized estimating equations to assess changes in ORS and zinc treatment during the program period.
resultsIn descriptive analysis, we found 38% (95% CI = 34%-42%) received ORS at baseline and 4% (95% CI = 3%-5%) received both ORS and zinc. At endline, we found 55% (95% CI = 51%-58%) received ORS and 30% (95% CI = 27%-33%) received both ORS and zinc. Adjusting for other covariates, the odds of diarrhea being treated with ORS were 1.88 (95% CI = 1.46, 2.43) times greater at endline. The odds of diarrhea being treated with ORS and zinc combined were 15.14 (95% CI = 9.82, 23.34) times greater at endline. When we include the interaction term to investigate whether the odds ratios between the endline and baseline survey were modified by source of care, we found statistically significant results among diarrhea episodes that sought care in the public and private sector. Among cases that sought care in the public sector, the predictive probability of treatment with ORS increased from 57% (95% CI = 50%-65%) to 83% (95% CI = 79%-87%). Among cases that sought care in the private sector, the predictive probability increased from 41% (95% CI = 34%-48%) to 58% (95% CI = 54%-63%).
conclusionsUse of ORS and combined ORS and zinc for treatment of diarrhea significantly increased in program states during the program period.
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