The present study explores whether packaging zinc with oral rehydration salts (ORS) will increase the combined use of both treatments in children (6-59 months) with acute diarrhea in eight districts of Ethiopia. The study also explored the cost-effectiveness of two co-packaging options: ‘central’ (zinc and ORS bundled using a pouch that had instructional message, distributed to health centers) and ‘health center’ (zinc, ORS and a similar pouch distributed to the HCs and bundled by health workers) level bundling.
A cluster-randomised controlled trial was used to compare adherence between ‘central bundling’, ‘health centre’ bundling, bundling without instructional message, and no bundling.
Bundling zinc with ORS using a pouch with instructional messages increases adherence to the treatment. ‘Health center’ level bundling was found to be more cost effective than ‘central bundling’.