Dr Arya


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Dr Arya

  1. 1. Promoting prevention and treatment of Diarrhoea:Increasing availability and USE of ORS and Zinc<br />Dr. Gaurav Arya<br />Health Specialist, UNICEF<br />October 30, 2010<br />
  2. 2. Overview of the presentation<br />Need for talking about diarrhoea<br />Components of effective management of diarrhoea using ORS and Zinc<br />Field challenges<br />Evidence on availability and use<br />Interventions for improving diarrhoea management in Uttar Pradesh<br />Brief introduction to the social marketing initiative in Lalitpur<br />
  3. 3. Why are we talking about diarrhoea<br /><ul><li>Diarrhoea is the second largest killer and accounts for nearly 2 million child-deaths globally
  4. 4. In India, only 26% children suffering from Diarrhoea are treated with oral rehydration therapy (ORT) and the proportion is only 13% in Uttar Pradesh (NFHS-3) – This is despite the fact that ORT was introduced as the treatment of choice for diarrhoea more than 3500 years ago.
  5. 5. More than one-quarter did not receive any kind of treatment
  6. 6. 16% received antibiotics, which are not normally recommended for treating childhood diarrhoea</li></li></ul><li>Components of effective management of diarrhoea using ORS and Zinc<br />Reduced mortality of children due to diarrhoea<br />
  7. 7. These are the field challenges<br />Diarrhoea is still a widely prevalent disease in UP (NFHS-3)<br />Most Childhood diarrhea cases first treated by rural practitioners and chemists (World Bank survey 1997)<br />Very low use of ORS and Zinc for management of diarrhoea<br />Rural Practitioners & Chemists use antibiotics extensively and have inadequate knowledge about the use of ORS & Zinc<br />Low compliance of Zinc for 14 days<br />There is no data on availability of ORS and Zinc through the private channels<br />Public health and distribution system has frequent outages and low reliability<br />There is continued and widespread use of anti-diarrheals <br />Govt. & professional bodies unwilling to educate or include the RMP’s<br />
  8. 8. Data shows…<br />There are multiple drug modalities being practiced<br />There are multiple drug therapies being used<br />
  9. 9. Data shows…<br />The general prescription pattern of service providers is inappropriate<br />Many of the retailers/ pharmacists have never retailed ORS and Zinc<br />
  10. 10. Pictures Show…<br />Here is where a large proportion of the population goes: RMPs<br />
  11. 11. Pictures Show…<br />And this is what they use for treatment:<br />
  12. 12. What are we doing in Uttar Pradesh<br /><ul><li>Capacity Development
  13. 13. Training of public healthcare providers in CCSP/IMNCI districts
  14. 14. Training of private and public sector pediatricians through IAP
  15. 15. Training of private physicians and pediatricians in Lalitpur through HLFPPT
  16. 16. Supply chain
  17. 17. Demonstrate a model of alternative supply chain through Social marketing initiative in Lalitpur
  18. 18. Provide buffer stock of ORS and Zinc to the public health system in CCSP/IMNCI districts</li></li></ul><li>What are we doing in Uttar Pradesh<br /><ul><li>Generating evidence and knowledge management
  19. 19. Market assessment for availability of ORS and Zinc
  20. 20. Promoting community use of ORS and Zinc through “depot holders” established by HLFPPT
  21. 21. GIS mapping and supply chain monitoring of depot holders in Lalitpur
  22. 22. Knowledge exchanges through academic associations and medical colleges
  23. 23. Establishing partnerships
  24. 24. Professional bodies like IAP, IAPSM
  25. 25. HLFPPT
  26. 26. Polio Social Mobilization Network
  27. 27. AED/ USAID funded PouZN project</li></li></ul><li>Social Marketing: A Social innovation<br />COMMUNITY EMPOWERMENT<br />SUSTAINABLE EFFORT<br /> HEALTH EDUCATION<br />ACCESS & QUALITY<br />ORS and Zinc<br />DOCTORS &<br />PHARMACIES<br />COMMUNITY<br />Connecting with the rural pharmacy and practitioners<br /> Sensitizing the Doctors<br />Meetings with depot holders<br />Community<br /> Meetings<br /> ORS and Zinc promotion – through depot holders<br />
  28. 28. Depot holder’s meetings<br />Awareness & Education<br />Physician Education <br />Social Marketing: A Social innovation<br />4 As of social marketing<br />Awareness<br />Community Awareness : Preventive Health tips, Disease and therapy awareness by local HLFPPT district and block teams<br />Physician and healthcare provider education: Knowledge sharing with doctors, ANMs, LHVs and AYUSH practitioners by Senior HLFPPT experts<br />Acceptability (Local)<br />Customized Portfolio: WHO recommended ORS(in sachet) and 7 tablet pack of Zinc (20mg Tablets) <br />Local adaptation of IEC material, branding & communication<br />Availability<br />Enhanced Distribution: Connecting rural pharmacies with city distributors across 700 villages in Lalitpur.<br />Affordability<br />Custom small packs (strips of 7 tabs costing Rs.8.25)<br />Affordable ORS packets (Rs.6.50 per packet)<br />
  29. 29. Social Marketing: A Social innovation<br />IEC Material<br />
  30. 30. THANKS<br />