Successful zinc supplementation scale-up in Nepal
According to the 2006 Nepal Demographic and Health Survey (NDHS), diarrhoea continues to be a major cause of childhood morbidity and mortality in the country, with 12% of children under five year of age experiencing diarrhoea.
The 2006 NDHS reported that nearly all mothers of children under five (97.8 per cent) knew about oral rehydration salts (ORS). However, only 29% administered ORS during bouts of diarrhoea and only 40% gave either ORS or increased fluids. Zinc was virtually unheard of in Nepal with only 0.4% of caregivers providing zinc during any bout of diarrhoea in the previous two weeks.
In 2005, the Ministry of Health and Population requested assistance from the United States Agency for International Development (USAID) to support the integration of zinc into the government’s diarrhoea management programme. In response, USAID has taken the lead in providing training and technical assistance to strengthen the skills of public sector health care providers in treating childhood diarrhoea with both ORS/ORT and zinc. At the same time, USAID/Nepal funded the global Social Marketing for Diarrhoea Disease Control Plus: Point-of-Use Water Disinfection and Zinc Treatment (POUZN) Project. The project introduces paediatric zinc in Nepal through the private sector. Both public and private sector programmes have now been implemented in 30 districts, encompassing 65% of the population
The POUZN programme in Nepal, although active nationwide for only six months, has already successfully contributed to an increase in zinc use from 0.4% in 2005 to nearly 16% in 2008. Of users, 85% correctly took zinc and ORS together, and 67% correctly took zinc for the full 10 days, demonstrating the positive impact of the communications messages.