The impact of co-packaging ORS and zinc – Mongu District, Zambia

The “co-packaging effect” was evident in a dispensing behaviours analysis conducted by ColaLife across eight health centres in Mongu District, Zambia, in October 2016 and October 2017. All eight centres had ORS and zinc in stock in October 2016; in addition, in October 2017, they all had co-packaged ORS and zinc. Before the introduction of co-packaged ORS and zinc in January 2017, the co-administration of ORS and zinc was already very high – six times the global average – at 44% of childhood diarrhea cases treated with both ORS and zinc. However, this rate doubled to 87% when co-packaged ORS and zinc were made available.

Diarrhoea Treatments Mongu 2016 and 2017
Proportion of children younger than 5 years treated with both oral rehydration salts and zinc packaged separately versus co-packaged, Mongu District, Zambia.

There was also evidence that antibiotic usage was reduced. See the full analysis which can be downloaded here: An analysis of diarrhoea treatments in Mongu districts following the introduction of the GRZ ORS/Zinc co-pack(PDF, 223 KB).

When asked in December 2017, whether anything had changed since receiving co-packaged ORS and zinc, and if so what, a district health director in Zambia replied:

Yes, what has changed is the availability especially of zinc, which is a part of [the co-pack] because I know previously we have never had problems with ORS availability but we have had problems when it came to zinc availability. But now that everything has been put into one kit, that has greatly improved the availability of zinc, which we know is important to limit the number of diarrhea cases and the duration of diarrhea. So the kit is really making an impact and it also serves as a reminder for us, as we are prescribing as health workers, that we do not forget zinc being an important component in the treatment of diarrhea.