Hello! We have just wrapped up a very busy period preparing for “Phase 2”, our first scale-up of ORSZ distribution, aiming to reach 20,000 children under-5 in two new areas in Kano, Nigeria. Community Health Workers concluded their distribution 2 weeks ago and we now await a set of follow-up surveys to ascertain how treatment of children’s diarrhoea changes.
Phase 2
What were our goals?
Go bigger, 3x scale-up from pilot, targeting distribution to 20,000 children under-5
Increase the robustness of the evaluation with a quasi-experimental design. Though this is not an RCT (due to a lack of true randomisation), we also survey nearby "no distribution" settlements for comparison.
Partner much more closely with existing primary healthcare structures (training and supervision of Community Health Workers and other staff) to increase scalability and reinforce the healthcare system.
Continued close collaboration with implementation partner, iDevPro Africa.
Expand to new local government areas (Dambatta and Wudil, Kano) in more rural settings.
How did it go?
We await the first follow-up survey (1 month after distribution) and have some analysis to do on baseline and operational monitoring data, but early signs are positive! Reports from the field teams indicate that distribution went ahead as planned, and though survey teams suffered transport disruption from heavy rains, they all returned safely having reached enough householders. We expect to have initial results later in June.
What next?
We have started planning for “Phase 3”, later in 2024. This continue scale-up with tests of several variants of the intervention to hone in on the most cost-effective approach. Here is some of our current thinking:
Consolidate government-led structure with our “Train the Trainer” model with existing primary healthcare staff.
Build sophistication in our use of GIS (Geographic Information Systems) to plan, distribute and evaluate with greater rigour.
Explore a platform-based strategy to ‘layer on’ different cost-effective interventions on top of ORS and zinc. More information on this will follow in the near future!
Explore different distribution modalities such as facility- or chemist-based distribution and compare the cost-effectiveness to our base model.
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