Factors that Influence Effective Diarrhea Treatment Programs in Haitian Children.
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Date
2015
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Abstract
Objectives: Childhood diarrhea is a major cause of morbidity and mortality in Haiti; a situation
exacerbated by the cholera outbreak in 2010. Oral rehydration salts (ORS), when combined with
zinc (ORS-zinc), is effective in preventing death and reduces severity of illness—yet their
combined use remains low. An intervention to expand delivery of ORS-zinc is underway. To guide
the scale up of the intervention, we conducted a qualitative study to identify caregivers’,
influencers’ and healthcare providers’ knowledge, attitudes and practices related to diarrhea and its
treatment.
Methods: Study conducted in two departments in Haiti: North West, where ORS-zinc distribution
has already begun, and North, where ORS-zinc will be implemented in 2014. Using rapid
ethnographic methods, we conducted 1) semi-structured interviews with both health workers of
traditional and modern medicine (n=16), 2) facility observations where child diarrhea is treated
(n=4), 3) six focus group discussions (FGD) with caregivers (n= 62) and influencers (n=39).
Results: All modern and most traditional health workers recommended ORS in their practice,
however, only those already receiving the intervention prescribed zinc while a few modern
practitioners in the non-intervention group had heard of it. Facility observations demonstrated a
gap in how the use of ORS-zinc is explained to patients. FGD showed that care seeking behaviour
is strongly influenced by perceptions of the type of diarrhea and availability of healthcare provider. Conclusions: Knowledge and attitudes affect the prescription and use of ORS-zinc. These
findings will affect the design of targeted behavior change interventions for scaling up ORS-zinc in
northern Haiti.
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Verney Allison, Nihorimbere Judith, Roche Marion, Pierre Joseline Marhone, Mohindra Katia. Factors that Influence Effective Diarrhea Treatment Programs in Haitian Children. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 1146-1147.