Formative Research to Develop and Test Messages to Educate Mothers on Zinc Supplementation in Childhood Diarrhea

Abstract

Background. Zinc is now recommended as part of childhood diarrhea case management but there are concerns regarding treatment duration and perceptions of its use when given with ORT.

Objectives. This study developed and tested messages on zinc supplementation for childhood diarrhea.

Methods. Messages were based on 1) a review of literature and product advertisements, 2) drugstore seller interviews, and 3) focus group discussions (FGDs) among 10 mothers with children six to 59 months old. Subsequent FGDs with 15 mothers consulting at a government hospital helped determine message clarity, comprehension and appeal. A behavioral trial, involving nine mothers whose children had diarrhea, tested recall of and adherence to the messages.

Results. The trial tested three messages—Zinc: 1) strengthens resistance; 2) is a vitamin for the gut; 3) increases the appetite of a child with diarrhea. Seven of nine mothers were able to follow instructions on zinc administration, and demonstrated recall and understanding of these messages. Mothers understood that zinc helps the child with diarrhea, improves appetite, reduces symptoms and hastens recovery, but had concerns regarding the side effects (vomiting), co-morbidities (fever, cough) and
consequences of overdose. Standardized counseling cards addressed these concerns. Respondents preferred a simple logo labeled “zinc” with zinc administration instructions on the packaging. Zinc supplementation did not affect ORT use.

Conclusion and Recommendations. Messages sufficiently addressed mothers’ concerns on zinc use during childhood diarrhea, with those on zinc improving “resistance” and as a “vitamin for the gut” having the best recall. Results can contribute to zinc’s introduction and promotion in the public sector.