Evidence map›Paper›PMID 38242636›Full record

ArticleGlobal health, science and practice2024

Institutionalizing Innovation: From Pilot to Scale for Co-Packaged Oral Rehydration Salts and Zinc-A Case Study in Zambia.

Jane Berry, Simon Berry, Elizabeth Chizema, Bonface Fundafunda, Davidson H Hamer, Stephen Tembo, Rohit Ramchandani

Open access · diamondAbstract read
In one paragraph

Article in Global health, science and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Jane BerryColaLife, London, United Kingdom.
Simon BerryColaLife, London, United Kingdom.
Elizabeth ChizemaAfrican Leaders Malaria Alliance, Zambia End Malaria Council; Formerly of Zambian Ministry of Health, Lusaka, Zambia.
Bonface FundafundaAfrica Resource Centre; Formerly of Medical Stores Limited, Lusaka, Zambia.
Davidson H HamerDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.
Stephen TemboRuralnet Associates Ltd., Lusaka, Zambia.
Rohit RamchandaniColaLife, London, United Kingdom. rramchandani@jhu.edu.
Balsillie School of International Affairs · CABoston University · USMinistry of Health · ZM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We document the development and institutionalization in Zambia of a health innovation for diarrhea treatment aimed at children aged younger than 5 years: a unique oral rehydration salts and zinc (ORSZ) co-pack. Seven recommendations from the World Health Organization/ExpandNet are used retrospectively to analyze and describe the successful scale-up of this innovation from its concept stage, including in-country expansion and policy, institutional, and regulatory changes. The 7 recommendations comprise using a participatory process, tailoring to the country context, designing research to test the innovation, testing the innovation, identifying success factors, and scaling up. The scale-up of co-packaged ORSZ in Zambia is shown to be sustainable. Five years after donor funding ended in 2018, an independent, local manufacturer continues to supply the private and public sectors on a commercially viable basis. Furthermore, national coverage of ORSZ increased from less than 1% in 2012 to 34% in 2018. A key success factor was the continuous facilitation over 8 years (spanning planning, trial, evaluation, and scale-up) by a learning and steering group chaired by the Ministry of Health, open to all and focused on learning transfer and ongoing alignment with other initiatives. Other success factors included a long lead-in of inclusive initial consultation, ideation, and planning with all key stakeholders to build on and mobilize existing resources, knowledge, structures, and systems; alignment with government policy; thorough testing and radical review of the product and its value chain before scale-up, including manufacture, distribution, policy, and regulatory matters; and adoption by the government of a co-packaging strategy to ensure cases of childhood diarrhea are treated with ORSZ. With appropriate local adaptations, this approach to scale-up could be replicated in other low- and middle-income countries as a strategy to increase coverage of ORSZ and potentially other health products.

Indexed as

SaltsZincChildDiarrheaFluid TherapyHumansRetrospective StudiesZambiaSaltsZinc

Identifiers

PMID38242636
PMCPMC10906556
OpenAlexW4391024287

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.