Introducing zinc in childhood diarrhea management: formative research helps address stakeholder concerns in the Philippines

Abstract

Formative research on the introduction of zinc in childhood diarrhea management aims to assess its feasibility and operational needs, as well as develop and test messages for mothers to use zinc appropriately. Interviews, focus group discussions, and behavioral trials were conducted in a metro‐Manila government hospital. Baseline interviews revealed that home remedies focused on changing the child's diet as diarrhea is perceived by mothers to be primarily food‐related. Messages developed focused on the actions of zinc on the gut, and built on commonly held perceptions about strengthening the child's resistance (pampatibay ng resistensya) and the popularity of vitamins (bitamina para sa tiyan). Mothers perceived diarrhea was cured faster, child's appetite and activity improved with zinc. There was excellent adherence to the 14 day zinc regimen even as diarrhea resolved within 2‐3 days on average. Additional concerns regarding the duration of treatment and side effects of zinc were raised during the trials and addressed through individual counseling. ORT use was not perceived to be affected by zinc intake in this urban setting where mothers have an understanding of dehydration's effects. Formative research is a useful preliminary phase for addressing specific program and stakeholder concerns through the development of appropriate communication strategies for a given setting. Support for this study was provided by WHO‐CAH.