The case for co-packaging of ORS and Zinc

GRZ ORS and Zinc co-pack

The case for co-packaging ORS and Zinc for the treatment of diarrhoea can be summarised as follows:

  1. The international recommendation[1] for the treatment of childhood diarrhoea is ORS combined with Zinc. ORS should be given as early as possible after the onset of the diarrhoea and continued until the diarrhoea stops. Zinc should be given daily for 10-14 days from the onset of the diarrhoea. This will mean that the Zinc will be administered for several days after the diarrhoea has stopped.
  2. When ORS and Zinc are distributed separately there is a high likelihood that they will not be dispensed together for several reasons:
    1. The supply of ORS and Zinc may be unbalanced so that either or both may be out of stock (see below)
    2. In resource-poor situations there may be a tendency to hold back Zinc for cases judged to be ‘severe’ and so Zinc is not given as a routine (when it should be)
    3. The person dispensing may not be aware of the correct treatment
  3. When ORS and Zinc are distributed separately, there is less chance that they will both be in stock at the same time. If the stocking rate for ORS is 50% and the stocking rate for Zinc is 40%, the stocking rate for both will be just 20%.


[1] WHO (2005) The treatment of diarrhoea – a manual for physicians and other senior health workers. ISBN: 9241593180
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