Tin Aung1, Dominic Montagu2, Hnin Su Su Khin1, Zaw Win1, Ang Kyaw San1, Willi McFarland3. 1. Research Department, Population Services International - Myanmar, Yangon, Myanmar. 2. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94105, USA. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94105, USACenter for Public Health Research, San Francisco Department of Public Health, San Francisco, CA 94102, USA willi_mcfarland@hotmail.com.
Abstract
BACKGROUND:Diarrhea's impact on childhood morbidity can be reduced by administering oral rehydration solution (ORS) with zinc; challenges to wider use are changing health-seeking behavior and ensuring access. METHODS: We conducted a randomized controlled trial to increase ORS plus zinc uptake in rural Myanmar. Village tracts, matched in 52 pairs, were randomized to standard ORS access vs. a social franchising program training community educators and supplying ORS plus zinc. RESULTS: Intervention and control communities were comparable on demographics, prevalence of diarrhea and previous use of ORS. One year after randomization, ORS plus zinc use was 13.7% in the most recent case of diarrhea in intervention households compared with 1.8% in control households (p < 0.001) (N = 3605). A significant increase in ORS plus zinc use was noted in the intervention (p = 0.044) but not in the control (p = 0.315) group. CONCLUSIONS:Social franchising increased optimal treatment of childhood diarrhea in rural Myanmar. Scale-up stands to reduce morbidity among children in similar settings. TRIAL REGISTRATION: Current Controlled Trials ISRCTN73606238.
RCT Entities:
BACKGROUND:Diarrhea's impact on childhood morbidity can be reduced by administering oral rehydration solution (ORS) with zinc; challenges to wider use are changing health-seeking behavior and ensuring access. METHODS: We conducted a randomized controlled trial to increase ORS plus zinc uptake in rural Myanmar. Village tracts, matched in 52 pairs, were randomized to standard ORS access vs. a social franchising program training community educators and supplying ORS plus zinc. RESULTS: Intervention and control communities were comparable on demographics, prevalence of diarrhea and previous use of ORS. One year after randomization, ORS plus zinc use was 13.7% in the most recent case of diarrhea in intervention households compared with 1.8% in control households (p < 0.001) (N = 3605). A significant increase in ORS plus zinc use was noted in the intervention (p = 0.044) but not in the control (p = 0.315) group. CONCLUSIONS: Social franchising increased optimal treatment of childhood diarrhea in rural Myanmar. Scale-up stands to reduce morbidity among children in similar settings. TRIAL REGISTRATION: Current Controlled Trials ISRCTN73606238.
Authors: Manoj Mohanan; Soledad Giardili; Veena Das; Tracy L Rabin; Sunil S Raj; Jeremy I Schwartz; Aparna Seth; Jeremy D Goldhaber-Fiebert; Grant Miller; Marcos Vera-Hernández Journal: Bull World Health Organ Date: 2017-03-24 Impact factor: 9.408