title: Impact of a social franchising program on uptake of oral rehydration solution plus zinc for childhood diarrhea in myanmar: a community-level randomized controlled trial.
abstract: BACKGROUND
  Diarrhea's impact on childhood morbidity can be reduced by administering oral rehydration solution (ORS) with zinc; challenges to wider use are changing health-seeking behavior and ensuring access.
  
  
  METHODS
  We conducted a randomized controlled trial to increase ORS plus zinc uptake in rural Myanmar. Village tracts, matched in 52 pairs, were randomized to standard ORS access vs. a social franchising program training community educators and supplying ORS plus zinc.
  
  
  RESULTS
  Intervention and control communities were comparable on demographics, prevalence of diarrhea and previous use of ORS. One year after randomization, ORS plus zinc use was 13.7% in the most recent case of diarrhea in intervention households compared with 1.8% in control households (p < 0.001) (N = 3605). A significant increase in ORS plus zinc use was noted in the intervention (p = 0.044) but not in the control (p = 0.315) group.
  
  
  CONCLUSIONS
  Social franchising increased optimal treatment of childhood diarrhea in rural Myanmar. Scale-up stands to reduce morbidity among children in similar settings.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN73606238.
authors.affiliation: Research Department, Population Services International - Myanmar, Yangon, Myanmar.
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94105, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Montagu
authors.affiliation: Research Department, Population Services International - Myanmar, Yangon, Myanmar.
authors.forename: Hnin
authors.initials: H
authors.lastname: Su Su Khin
authors.affiliation: Research Department, Population Services International - Myanmar, Yangon, Myanmar.
authors.forename: Zaw
authors.initials: Z
authors.lastname: Win
authors.affiliation: Research Department, Population Services International - Myanmar, Yangon, Myanmar.
authors.forename: Ang Kyaw
authors.initials: AK
authors.lastname: San
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94105, USACenter for Public Health Research, San Francisco Department of Public Health, San Francisco, CA 94102, USA willi_mcfarland@hotmail.com.
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
mesh_terms: D001639:Bicarbonates / Q000008:administration & dosage; D002648:Child; D003153:Community Health Services / Q000458:organization & administration; D003967:Diarrhea / Q000628:therapy*; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D062489:Health Impact Assessment; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D002052:Myanmar / Q000453:epidemiology; D011189:Potassium Chloride / Q000008:administration & dosage; D015995:Prevalence; D017149:Private Sector; D015397:Program Evaluation; D015532:Rehydration Solutions / Q000008:administration & dosage*; D012423:Rural Health; D012424:Rural Population; D040241:Social Marketing; D012965:Sodium Chloride / Q000008:administration & dosage; D015032:Zinc / Q000008:administration & dosage*
chemical_list: D001639:Bicarbonates; D015532:Rehydration Solutions; C044142:World Health Organization oral rehydration solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D005947:Glucose; D015032:Zinc
keywords: Myanmar; cluster randomized trial; diarrhea; oral rehydration solution; zinc