Effectiveness of peer detailing in a diarrhea program in Nigeria

Abstract

Diarrhea causes more than 500,000 deaths of children younger than 5 years, globally, each year. A combination of oral rehydration salts (ORS) and zinc is regarded as the most effective treatment to prevent diarrhea-related deaths among children. We study the effectiveness of a program in Nigeria aimed at increasing usage of ORS and zinc. Peer detailers (educators) reinforce the benefits of the treatment to patent and proprietary medicine vendors (PPMVs), a main source of healthcare in the country. Two aspects of program effectiveness are analyzed: 1) PPMV knowledge that this combination is the most effective treatment and 2) PPMV inventory of ORS and zinc. Hypothesis tests reveal that the percentage of PPMVs with knowledge of the most effective treatment increases significantly in most of the tested Nigerian states after peer detailing. Surprisingly, no significant patterns were detected regarding the percentage of PPMVs with inventory of ORS and zinc. Logistic regression results suggest that PPMVs that were detailed have significantly higher odds ratios for both knowledge and inventory. We discuss our findings regarding the overall effectiveness of the program and the limitations of the study, as well as suggestions for future activities to support information dissemination.