Zambia:
Commercially branded co-packaged ORS and zinc – Kit Yamoyo (left) | Government branded co-packaged ORS and zinc (right)
The latest Demographic & Health Survey (DHS, 2019) has just been published for Zambia. These surveys are undertaken every five years under the DHS Program. The report just published for Zambia (PDF 1.4MB) shows a dramatic change in the use of zinc for diarrhoea treatment since we began our work in 2012.
Our trial baseline survey in 2012 indicated that less that 1% of cases of diarrhoea were treated with zinc despite this being the global recommendation since 2004 (WHO/UNICEF). The level of zinc usage was the same in 2013 in our comparator trial areas while in our intervention areas, we achieved a zinc treatment rate of 47% by making co-packaged ORS and zinc available through the private sector.
In the scale-up of our work we reached zinc treatment rates of 33% in Lusaka where our co-packaged ORS and zinc was only available through the private sector and a treatment rate of 53% in selected rural districts where our co-packaged ORS and zinc was available through both the private and public sectors. Since the end of our presence in Zambia, production for the private sector has continued and the Zambian Government has added co-packaged ORS and zinc to their Essential Medicines List and has purchased co-packaged ORS and zinc from the local manufacturer.
The DHS survey in 2013/14 didn’t even measure zinc usage but the indication is that it would have been less than 1%. The latest DHS survey (2019) shows national treatment rates with both ORS and zinc of 34%.
We obviously can’t take credit for all this improvement, but we will have contributed significantly to it, both through our work on the ground to get co-packaged ORS and zinc in supermarkets, small shops and government clinics, and at the policy level to get co-packaged ORS and zinc on the Zambia Essential Medicines List (EML).
The following table shows how dramatic these changes have been.
| ColaLife Trial |
DHS | ColaLife Scale-up |
DHS | |||||
| 2012 | 2012 | 2013 | 2013 | 2013/14 | 2018 | 2018 | 2019 | |
| Indicator | Comparator areas (baseline)* |
Inter-vention areas (baseline)* |
Comparator areas (endline)* |
Inter-vention areas (endline)* |
DHS National averages | Year 3 of Lusaka scale-up** | Year 3 of rural scale-up*** | DHS National averages |
| ORS taken (with or without zinc) |
66% | 60% | 58% | 76% | 70%^ | 72% | 90% | 67% |
| Zinc taken (with or without ORS) |
<1% | <1% | <1% | 47% | – | 39% | 53% | 39% |
| ORS and zinc | <1% | <1% | <1% | 47% | – | 33% | 53% | 34% |
* ColaLife Operational Trial in Zambia (COTZ)
** Kit Yamoyo Transition to Scale – Lusaka (KYTS-LUSAKA)
*** Kit Yamoyo Transition to Scale – Rural Areas (KYTS-ACE)
^ Figure refers to ORT – either ORS or recommended home fluids; ORS packets specifically were not disaggregated in 2013/14
Onwards and upwards.
