A study to evaluate the acceptability, feasibility and impact of packaged interventions (“Diarrhea Pack”) for prevention and treatment of childhood diarrhea in rural Pakistan

Habib, Atif; Soofi, Sajid Bashir; Sadiq, Kamran; Samejo, Tariq; Hussain, M. Azmat; Mirani, Mushtaq; Rehmatullah, Asmatullah; Ahmed, Imran; Bhutta, Zulfiqar A

doi:10.1186/1471-2458-13-922

Cited by 18 publications

(27 citation statements)

References 25 publications

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“…Some research entails on interventions for the prevention of diarrhoea just to focus on the perspective of hygiene (Dreibelbis, Freeman, Greene, et al, 2014;Galvez, Neish, Balabarca, et al, 2010;Jenkins, Anand, Revell, et al, 2013) or diarrhoea case management, such as the use of ORS (Ghimire, Pradhan, & Maskey, 2010;Habib, Soofi, Sadiq, et al, 2013). However, other factors can interfere in the prevalence of childhood diarrhoea, such as the care with food (Agustina, Sari, Satroamidjojo, et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

The use of educational video to promote maternal self‐efficacy in preventing early childhood diarrhoea

Joventino

Ximenes

Penha

et al. 2017

Int J of Nursing Practice

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Diarrhoea is responsible for high rates of infant morbidity and mortality. It is multifactorial, manifested by socioeconomic, hygienic, and maternal factors. The aim of this study is to evaluate the effects of an educational video on maternal self-efficacy for the prevention of childhood diarrhoea. This was a randomized trial conducted in the state of Ceará, Brazil. Participants were 2 groups (comparison and intervention), composed of mothers of children under 5 years of age. Group membership was allocated by cluster randomization. Outcomes were maternal self-efficacy measured using the Maternal Self-efficacy Scale for Prevention of Early Childhood Diarrhoea; outcome data collectors were blinded to group allocation. Ninety participants were randomized to each group; 83 intervention group and 80 comparison group members were contained in the final analysis. Maternal self-efficacy in preventing childhood diarrhoea increased in both groups, but average scores of the intervention group were higher at all time than those of the comparison group. The educational video had a significant effect on maternal self-efficacy.

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Section: Discussionmentioning

confidence: 99%

The use of educational video to promote maternal self‐efficacy in preventing early childhood diarrhoea

Joventino

Ximenes

Penha

et al. 2017

Int J of Nursing Practice

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“…Although some authors have argued that there is insufficient evidence on efficacy and effectiveness of community management of pneumonia [ 12 ], the data suggest that if the WHO-iCCM algorithm [ 30 ] could be followed by CHWs, the implementation of iCCM alone in this predominantly rural setting would lead to 32.7 % increase in the number of children with pneumonia symptoms receiving appropriate antibiotics, and a 40.0 % increase in the number of children with diarrhoea receiving ORS. The high ORS uptake combined with low zinc uptake highlights the need to explore the untapped strategy of co-packaging ORS and zinc, which has proven to improve uptake of diarrhoea treatment elsewhere [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Yet careful consideration of the common challenges CHWs face delivering high quality care in an isolated rural environment is needed, especially to address lack of supervision and drug supply, which negatively affect CHW performance and subsequently programme outputs [ 12 , 33 – 35 ]. There is also a need to implement and evaluate simple interventions that can increase uptake of zinc, like co-packaging of ORS with zinc, as these might serve to improve overall uptake of effective diarrhoeal treatments [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of an integrated community case management programme on uptake of appropriate diarrhoea and pneumonia treatments in Uganda: A propensity score matching and equity analysis study

Nanyonjo

Ssekitooleko

Counihan

et al. 2015

Int J Equity Health

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IntroductionPneumonia and diarrhoea disproportionately affect children in resource-poor settings. Integrated community case management (iCCM) involves community health workers treating diarrhoea, pneumonia and malaria. Studies on impact of iCCM on appropriate treatment and its effects on equity in access to the same are limited. The objective of this study was to measure the impact of integrated community case management (iCCM) as the first point of care on uptake of appropriate treatment for children with a classification of pneumonia (cough and fast breathing) and/or diarrhoea and to measure the magnitude and distribution of socioeconomic status related inequality in use of iCCM.MethodsFollowing introduction of iCCM, data from cross-sectional household surveys were examined for socioeconomic inequalities in uptake of treatment and use of iCCM among children with a classification of pneumonia or diarrhoea using the Erreygers’ corrected concentration index (CCI). Propensity score matching methods were used to estimate the average treatment effects on the treated (ATT) for children treated under the iCCM programme with recommended antibiotics for pneumonia, and ORS plus or minus zinc for diarrhoea.FindingsOverall, more children treated under iCCM received appropriate antibiotics for pneumonia (ATT = 34.7 %, p < 0.001) and ORS for diarrhoea (ATT = 41.2 %, p < 0.001) compared to children not attending iCCM. No such increase was observed for children receiving ORS-zinc combination (ATT = -0.145, p < 0.05).There were no obvious inequalities in the uptake of appropriate treatment for pneumonia among the poorest and least poor (CCI = -0.070; SE = 0.083). Receiving ORS for diarrhoea was more prevalent among the least poor groups (CCI = 0.199; SE = 0.118). The use of iCCM for pneumonia was more prevalent among the poorest groups (CCI = -0.099; SE = 0.073). The use of iCCM for diarrhoea was not significantly different among the poorest and least poor (CCI = -0.073; SE = 0.085).ConclusioniCCM is a potentially equitable strategy that significantly increased the uptake of appropriate antibiotic treatment for pneumonia and ORS for diarrhoea, but not the uptake of zinc for diarrhoea. For maximum impact, interventions increasing zinc uptake should be considered when scaling up iCCM programmes.

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“…Other evaluations of prepackaged medicines had similarly favorable findings. There were high levels of acceptability and utilization of contents among mothers in Pakistan provided with a prepackaged intervention, including oral rehydration salts and Zinc tablets distributed for home use and aimed at diarrhea treatment for their young children [ 18 ]. A “mama kit” implemented in Uganda containing preventative malaria treatment was also accepted by the pregnant women to whom it was administered [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnant and Postpartum Women’s Experiences and Perspectives on the Acceptability and Feasibility of Copackaged Medicine for Antenatal Care and PMTCT in Lesotho

Gill

Hoffman

Tiam³

et al. 2015

AIDS Research and Treatment

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Objective. To improve PMTCT and antenatal care-related service delivery, a pack with centrally prepackaged medicine was rolled out to all pregnant women in Lesotho in 2011. This study assessed acceptability and feasibility of this copackaging mechanism for drug delivery among pregnant and postpartum women. Methods. Acceptability and feasibility were assessed in a mixed method, cross-sectional study through structured interviews (SI) and semistructured interviews (SSI) conducted in 2012 and 2013. Results. 290 HIV-negative women and 437 HIV-positive women (n = 727) participated. Nearly all SI participants found prepackaged medicines acceptable, though modifications such as size reduction of the pack were suggested. Positive experiences included that the pack helped women take pills as instructed and contents promoted healthy pregnancies. Negative experiences included inadvertent pregnancy disclosure and discomfort carrying the pack in communities. Implementation was also feasible; 85.2% of SI participants reported adequate counseling time, though 37.8% felt pack use caused clinic delays. SSI participants reported improvement in service quality following pack introduction, due to more comprehensive counseling. Conclusions. A prepackaged drug delivery mechanism for ANC/PMTCT medicines was acceptable and feasible. Findings support continued use of this approach in Lesotho with improved design modifications to reflect the current PMTCT program of lifelong treatment for all HIV-positive pregnant women.

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A study to evaluate the acceptability, feasibility and impact of packaged interventions (“Diarrhea Pack”) for prevention and treatment of childhood diarrhea in rural Pakistan

Cited by 18 publications

References 25 publications

The use of educational video to promote maternal self‐efficacy in preventing early childhood diarrhoea

The use of educational video to promote maternal self‐efficacy in preventing early childhood diarrhoea

Impact of an integrated community case management programme on uptake of appropriate diarrhoea and pneumonia treatments in Uganda: A propensity score matching and equity analysis study

Pregnant and Postpartum Women’s Experiences and Perspectives on the Acceptability and Feasibility of Copackaged Medicine for Antenatal Care and PMTCT in Lesotho

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