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The effectiveness bundling of zinc with Oral Rehydration Salts (ORS) for improving adherence to acute watery diarrhea treatment in Ethiopia: cluster randomised controlled trial

Publication Details

Authors: Samson Gebremedhin, Girma Mamo, Henock Gezahign, Jacqueline Kung’u, and Abdulaziz Adish
Publication date: 31 May 2016
Source: BMC Public Health. Volume 16, No. 457: pp 1-10


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’.



Africa, Ethiopia, Research Documents, Supplementation, Zinc