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UNICEF Innovation

ORS and Zinc Co-Pack

Diarrhoeal disease is the second leading cause of death in children under five, killing approximately 760,000 children per year. Diarrhoea can last several days, and can leave the body without the water and salts that are necessary for survival.

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ORS & Zinc Co-Pack

OVERVIEW 

This project is an investigation into how bundling of zinc and oral rehydration salts (ORS) can reduce the number of deaths from diarrhoeal disease through improved use of oral rehydration therapy. 

Challenge to current model

Globally, there are about two billion cases of diarrhoeal disease every year, resulting in 760,000 deaths of children under 5. 80% of these occur in Africa and South Asia. Additionally, diarrhoea is a leading cause of malnutrition in children under five years old. 

In response, just 39% of children with diarrhoea receive ORS. This contains the salts and sugar which help the child to absorb water to replace that is lost during diarrheal episodes. As well as ORS, a 10-14 day course of zinc, reduces the duration of the episode as well as its incidence and severity of diarrhoea in the subsequent months. Feedback from the field suggests caregivers do not complete the full 10-day programme of zinc in combination with the 2-day programme of ORS, as they are confused about treatment guidelines.

Proposed solution

This project is an investigation into how bundling of zinc and ORS can reduce the number of deaths from diarrhoeal disease through an ORS & Zinc co-pack with a depictive instruction leaflet.

Currently, UNICEF separately procures dispersible zinc tablets and dissolvable oral rehydration salts (ORS) for treatment of diarrhoea. ORS is procured in different sized plain and orange flavoured sachets which is mixed with water to make either a 500 ml or 1L solution depending on the age of the child. Zinc is procured in blister packs of 10 dispersible tablets. Instructions for use are not printed on the blister pack, but provided separately in the co-pack although one instruction leaflet is included in a supplied box of 100 blister packs. 

ORS flavoured 500 ml x 4 + Zinc 20 mg 10 tablets / pack

ORS flavoured 1 litre x 2 + Zinc 20 mg 10 tablets / pack

 The table below illustrates WHO's recommendation on diarrheal treatment for children of various ages:

Table 1 WHO’s Childhood Diarrhoea Treatment Protocol

[1]

Age

Diarrhoea (less than 14 days AND no blood in stool)

2-6 months

2 x 20.5 g ORS sachets (min. 125 ml after each episode) + ½ x 20 mg Zinc tablet / day x 10 days

6-59 months

2 x 20.5 g ORS sachets (min. 125 ml after each episode) + 1 x 20 mg Zinc tablet / day x 10 days

Source: WHO

[1] World Health Organization, Integrated Management of Childhood Illness: Caring for New-borns and Children in the Community. Manual for the Community Health Worker: Caring for the Sick Child in the Community, Treat Diarrhoea, Confirmed Malaria and Fast Breathing, WHO, Geneva, 2011, p. 65.


 

 

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