Public-private Partnership Approaches for Scaling up Zinc with ORS

Abstract

Objectives: Based on evidence from four previous private sector programs, USAID's SHOPS project, in partnership with the Ghana Health Service,  developed a strategy to maximize availability of, demand for, and use of zinc plus oral rehydration solution (ORS) for the treatment of pediatric diarrheas. This abstract describes the private sector-focused strategy for addressing high diarrhea prevalence among children under five in Ghana. Methods: SHOPS established a conducive policy and regulatory environment, engaging stakeholders from both sectors; collaborated with regulatory bodies to train over 10,000 chemical sellers and pharmacy staff and 350 clinicians in diarrhea management; partnered with pharmaceutical manufacturers to increase availability of quality, affordable products; developed an innovative campaign to increase awareness and demand; and partnered with NGOs to promote use through community mobilization. We conducted in-depth interviews and mystery client surveys with providers to assess reported and actual prescribing behavior. Results: Private sector sales of zinc tablets increased ten-fold after training providers and 300% after the media campaign, treating over 2 million children with diarrhea to date. Most (75%) providers mentioned zinc as their preferred diarrhea treatment; 65% actually prescribed zinc with ORS as treatment. Retail audits confirm over 60% of chemist shops and pharmacies carry zinc and ORS.  These results are notable in that zinc was completely unknown and unavailable in Ghana prior to the initiation of the program in 2012. Conclusions: In a single year, significant progress in scaling up diarrhea treatment was realized through strategic partnerships with the private sector in Ghana.