Understanding Barriers and Facilitating Factors for Uptake of Zinc and ORS in Kenya; a case of Kitui County
Elijah Mbiti *
Micronutrient Initiative, Nairobi, Kenya.
Catherine Lengewa
Essence International, Nairobi, Kenya.
Jacqueline Kung'u
Micronutrient Initiative, Nairobi, Kenya.
Stewart Kabaka
Ministry of Health, Nairobi, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Diarrhea is a key public health challenge in Kenya with a prevalence of 17% and contributes to 21% of underfive child deaths. Whereas effective treatment is available, its uptake is very low with 39% and less than 1% receiving ORS and Zinc respectively. Current diarrhea prevention and treatment approaches are generalized thus missing out on regional variability, challenges and uniqueness. The objective of this paper is to explore factors that facilitate or hinder diarrhea management in one region in Kenya.
Methods: Cross sectional study employing both quantitative and qualitative approaches involving 764 household interviews, 15 key informant interviews and 10 focus group discussions targeting caregivers of children below five years, key influencers, and community health workers in the two districts and 8 health facilities.
Results: Key facilitating factors: Availability of diarrhea policy, zinc/ORS at public health facilities for free, good knowledge by caregivers on ORS for diarrhea treatment (85%), need for child with diarrhea to drink more fluids (90%) and that diarrhea is life threatening (93%). Key barriers include poor health seeking behavior for diarrhea, limited access to diarrhea messages, misconception that only children with 5 or more loose stools need treatment, cultural practices like gum massage during teething which lead to contamination hence diarrhea, inappropriate treatment practices (use of herbs and body piercing), low uptake of zinc and ORS, non-participation by men and challenges with water and sanitation.
Conclusions: Kitui experiences unique challenges related to knowledge, cultural practices which hinder appropriate diarrhea management and must be overcome through region-specific program adaptations.