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J Trop Pediatr. 2014 Jun;60(3):189-97. doi: 10.1093/tropej/fmt108. Epub 2014 Jan 8.

Impact of a social franchising program on uptake of oral rehydration solution plus zinc for childhood diarrhea in myanmar: a community-level randomized controlled trial.

Author information

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.

KEYWORDS:

Myanmar; cluster randomized trial; diarrhea; oral rehydration solution; zinc

PMID:
24401752
DOI:
10.1093/tropej/fmt108
[Indexed for MEDLINE]
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