Objectives
Diarrheal disease is second leading cause of morbidity and mortality in children below five in Kenya. Although Zinc and ORS is the recommended treatment and is available at traditional sources (Public Health facilities); over 90% of children with diarrhea do not access. We explored the potential of non-conventional outlets (community level shops, schools and faith based groups) to increase caregivers’ knowledge and treatment practices
Methods
Cluster randomized controlled trial conducted at Narok County at community with poor access to health services. The study was implemented over 17 months between 2013 and 2015 in 22 clusters. The study focused on behavior change communication activities to caregivers, community leaders and shop owners; commodity supply chain on flow of treatment kits from the manufacturer to the outlets and training shop owners, the religious group leaders and the school teachers. Ethical clearance was obtained from AMREF Ethical review board. Appropriate models were used for inter-cluster and study arm comparisons
Results
Baseline: 6683 households (10,989 children). End line 6,720 households (10,623 children) were sampled. Knowledge on diarrhea significantly increased from 11.8% to 42.6% (baseline vs end line) at comparison arm (p<0.001) and from 8.3% to 52.0% (p<0.001) in the intervention arm, a 12.9% change attributable to the intervention. Use of Zinc and ORS: change attributable to intervention (effect size) was 23.8%. The change attributable to the intervention on overall appropriate caregiver practices (effect size) was 13.5%
Conclusions
Non-conventional platforms were successful in increasing caregivers’ knowledge on diarrhea, use of zinc and ORS and, influencing diarrhea management practices
