NewsPatrolling.com 27 October 2021: Sustaining Health Outcomes through the Private Sector (SHOPS) Plus, the flagship private sector health initiative supported by the U.S. Agency for International Development (USAID), released a report highlighting the severity of diarrhea in India and the impact on child mortality. The report recommends the use of a combined first line treatment of oral rehydration salt (ORS) and zinc, as recommended by the World Health Organization (WHO). SHOPS Plus in India utilizes digital media and “On the Ground activities” to promote ORS and zinc as the first line of treatment for diarrhea management.
Sangita Patel, Health Office Director, USAID/India, stated, “USAID’s health programs improve the quality of care at birth and help reduce pneumonia, diarrhea, and malnutrition—the leading causes of child death. This report is meant to apprise policy makers, health care experts and society at large on the urgent need to build awareness for the WHO-approved treatment for diarrhea and address the existing gap in information dissemination. While policy makers have made earnest efforts to address all potential barriers to access both ORS and zinc, there is a need to build awareness among key stakeholders about the importance of using both ORS and zinc as a first line of treatment. An incorrect treatment using a rehydration drink or an incomplete treatment using just ORS without zinc can prove detrimental to children’s health. There is a need for the private sector to step up and initiate these conversations across society, and all concerned stakeholders to come together to move the needle.”
Komal Khanna, SHOPS Plus Chief of Party, Abt Associates shared her thoughts on the need for increased awareness of ORS and zinc. “Despite the best efforts by the government and various public bodies, the overall awareness for the importance of using both ORS and zinc as the first line of treatment for diarrhea remains low, especially among caregivers. This report reinforces the urgency, along with establishing lifesaving properties, safety, and cost-effectiveness of ORS and zinc, for the treatment of diarrhea in children.”
SHOPS Plus allows messages to be tailored and provide clients with an opportunity to engage directly with health products and information, including sample packets of ORS. This initiative was part of the project’s broader campaign on diarrhea management, in which the project mobilized mass media and digital platforms such as Facebook page, and the hashtag #mylittleshararat (or my little mischief).
The increase in the occurrence of diarrhea in India during the past decade, from 9 to 9.2 percent, underscores the need to address this leading cause of death among children under five. India continues to record one of the world’s highest rates of child mortality due to diarrhea (close to 200,000 children under the age of five die of diarrhea every year).
Awareness of proper treatment remains low, and few people follow the WHO recommendation to give more liquids to sick children. In 2015, only 7 percent of children under five with diarrhea in India received more liquids than usual, down from 10.2 percent in 2005 (2015–16 National Family Health Survey). Caregivers commonly perceive ORS and zinc as supplements instead of medicine, and prematurely discontinue them as soon as symptoms subside. Knowledge about the efficacy, as well as the accessibility, of zinc remains low. Almost 80 percent of prescriptions include an antibiotic – which is not required in most cases of diarrhea. Repeated treatment with antibiotics leads to development of antimicrobial resistance and lowers the child’s immunity, increasing the risk of future infections.
The WHO-recommended ORS formulation is a trademark Class 5 pharmaceutical product, and its price is regulated under the National Pharmaceutical Pricing Authority. There are many imitation rehydration options in the market with names closely resembling the WHO- recommended ORS. In its analysis, SHOPS Plus found a myriad of ORS-like products in the market (including some not recommended by WHO), which can impede the uptake of appropriate treatment. Valued at 3.6 billion rupees or 48 million dollars, the Indian market for ORS struggles with retailers selling imitation, substandard rehydration drinks that are less effective in treating diarrhea in children under five.About the SHOPS Program: The Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AIDOAA-A-15-00067) funded by the United States Agency for International Development. The project strategically engages the private sector to improve health outcomes in family planning, HIV, maternal and child health, and other health areas. Abt Associates implements SHOPS Plus in collaboration with the American College of Nurse-Midwives, Avenir Health, Broad Branch Associates, Banyan Global, Insight Health Advisors, Iris Group, Population Services International, and the William Davidson Institute at the University of Michigan.
