Impact of Training on Diarrhoea Management
Condition: Acute Childhood Diarrhea
MeSH terms: Diarrhea
Study type: Interventional

Summary: 
      Alternative, sustainable interventions in support of zinc treatment for childhood diarrhea
      need to be identified. Within the NGO sector, direct provision of health services is
      provided, however some NGOs also work closely with the private sector providers.
      Hypothetically, this avoids unnecessary duplication of effort and enhances the quality of the
      care provided in the private sector. This study will provide objective evidence of the impact
      of this approach, using the scale-up of zinc for the treatment of childhood diarrhoea as a
      test case. The study will be assessing NGO impact among unregulated (unlicensed), rural
      service providers. Further, this study will serve to assess the value of this model of
      scaling up activities in the non-state sector with a particular eye toward more generalizable
      and replicable improvement in quality of care strategies between NGOs and unlicensed private
      providers. This will be controlled before-after (CBA) study. An equivalent control area will
      be included in the study. The objective is to document changes in zinc and antibiotic as well
      as anti-diarrhoeal usage in childhood diarrhea following a scale-up intervention package
      delivered by a local NGO to local private providers. This will include sensitization,
      training and follow-up support. Impact will be assessed in terms of changes in zinc coverage
      and antibiotic use among households in the catchment population served by these providers.
      The study will be conducted in four unions located in Sreepur Upazila within Gazipur
      district, located north to Dhaka. Two of the unions, namely Rajabari and Prohladpur
      comprising 55 villages with 15,530 households and an estimated 76,150 population will serve
      as intervention area. The other two unions Telihat and Barmi will be taken as control sites.
      They contain 53 villages with 19,898 households and an estimated 99,000 population. The
      curative health services in these sites are provided by local drug vendors, village
      practitioners, traditional healers, and licensed government, private or NGO health service
      providers. Data will be collected through survey and in-depth interviews. Data will be
      entered and analyzed using SPSS version 12.0. Absolute counts, proportions, and means with
      95% confidence interval will be calculated. These and regression analysis will be done using
      STATA version 9, cluster survey program, that accounts for potential within cluster
      homogeneity. Based upon the household surveys, the outcomes that will be calculated are:
      coverage-the proportion receiving zinc, ORS (zinc and ORS), and antibiotics or
      antidiarrhoeals and changes in coverage 6 months following the introduction of the
      intervention package, equity: who is receiving zinc by age, gender and socioeconomic status.
      For differences in categorical outcomes crude relative risks and 95% confidence intervals
      will be determined. It is expected that the study will help in increasing zinc coverage for
      the treatment of children under five years of age and decrease in the use of antibiotics and
      antidiarrhoeals within the NGO catchment population.
    


Intervention name(s): Training intervention
Intervention type(s): Behavioral
Intervention description(s): Intervention group service providers received intervention training
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Care Provider)
Primary purpose: Health Services Research
Keywords: NGO zinc scale; compliance with WHO zinc treatment recommendations