1) Public health institutions and academia can play an important role in increasing prescription of ORS and zinc for diarrhoea management by endorsing the government's policy. 2) Their involvement lends credibility and convinces the public, as their opinion matters. It also gives value to recommended treatment products. 3) Faculty members should promote ORS and zinc use through teaching, training, research and advocacy because diarrhoea control is a national priority and improving treatment is within their academic and clinical interests. Increased prescription of ORS and zinc can reduce the burden of diarrhoeal diseases in India.

1. Role of Public Health Institutions and Academia in Increasing the Prescription of ORS and Zinc for Diarrhoea Management Dr. V.K. Srivastava, Professor of Social & Preventive Medicine & Head, Department of Hospital Administration, CSM Medical University, Lucknow

2. Govt. of India Policy on use of Zinc in National Programme for Management of Diarrhoea: Zinc (20mg/day for 14 days) is to be used in national programme as an adjunct to ORS in the management of diarrhoea in children older than 3 month to reduce duration and severity of acute diarrhoea (Govt. of India, 2006).

3. Why involve Public Health Institutions/ faculty members? Because: Their opinion matters Their involvment gives value to the products Their endorsement is convincing to people.

4. Public Health Institutions VISION Healthy people in healthy community MISION Development of appropriate health man power for comprehensive health care

5. Academia/Faculty Members are associated with: Development of Health Manpower (country’s need specific), and Offer solutions to tackle health problems by carrying out research - both basic and applied

6. Why faculty members should involve themselves? Is it of National significance? Is it of Academic/Clinical interest? Whether any value attached to it? Is it within the purview of MCI ? It is convincing? Not much work done in this field? Scope for further research?

7. Whether issue is of National Interest?

8. National Diarrhoea Disease control Programme Goal Reduce diarrhoeal associated mortality in children under the age of 5 years by 30% by 1995 and by 70% by 2000 AD. Reducing case fatality rate to less than 1%.

9. It is convincing? Enough evidence available Recommended by UNICEF/WHO. Govt. of India Policy

11. Is it within the Purview of MCI ?

12. THE POSTGRADUATE MEDICAL EDUCATION – MCI-REGULATIONS, 2000 - SALIENT FEATURES The goal of postgraduate medical education shall be to produce competent specialists and/or Medical teachers who : Shall recognize the health needs of the community, and carry out professional obligations ethically and in keeping with the objectives of the national health policy Shall have mastered most of the competencies, pertaining to the speciality, that are required to be practiced at the secondary and the tertiary levels of the health care delivery system;

13. THE MCI REGULATIONS ON GRADUATE MEDICAL EDUCATION, 1997 - SALIENT FEATURES At the end of undergraduate program, the medical students should be able to : (a) Recognize “health for all” as a national goal and health right of all citizens and by undergoing training for medical profession fulfil his/her social obligations towards realization of this goal. (b) Learn every aspect of National policies on health and devote himself/herself to its practical implementation. (c) Appreciate rationale for different therapeutic modalities, be familiar with the administration of the "essential drugs" and their common side effects.

14. Work done by Medical Colleges in UP-UK in use of promoting use of Zinc in Diarrhoea

16. SELECTED CITIES FOR the COMMUNITY MODEL

17. Approach: Step wise Step 1- Training and detailing of local HCPs about Zinc and diarrhea management Step 2- Spreading awareness about Zinc and diarrhea management amongst consumers

18. IMPACT ASSESSMENT Correct knowledge about Zinc Therapy Change or adaptation among providers Reduction in prescription of other medicines

19. How to accomplish the task by Academia/Faculty? Through Teaching Training Research Others

20. 1. Teaching/Training: Undergraduates Postgraduates Interns Others- ICDS, NGOs etc.

23. Ph.D.

25. Advocacy for Promoting ORS/Zinc use: Within professional groups Meeting/Conferences Seminar/symposia Others groups Schools NGOs Communities

26. Challenges Low ORS use rates Irrational use of antimicrobials & other drugs Very-very low use rate of Zinc in Diarrhoea Inappropriate management of dehydration Inadequate emphasis on feeding

27. Ultimate Goal The revised recommendations must become routine practice both in the home and health facility

28. Thank you