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Designing Co-packaging for zinc and Oral Rehydration Salts (ORS) to Influence Caregiver and Provider Behaviours for Treating Childhood Diarrhoea in Guatemala

The objective of this study was to design an effective co-packaging for zinc and ORS, informed by social-marketing, to influence both caregivers’ and providers’ behaviors in a demonstration project. Local concepts, perceptions and experiences relating to diarrhea and care seeking were explored in 8 focus group discussions (n=82) and 24 key informant interviews with caregivers at the health post level in the department of San Marcos, Guatemala. Prototype co-packaging and messages were developed and reviewed with 14 mothers and 10 providers in 4 municipalities to pretest the candidate materials. The formative research identified two major challenges to correctly using zinc and ORS to treat childhood diarrhea with regards to: 1) the concept of adherence to zinc once symptoms disappeared; and 2) dissolving a tablet in a spoon was a new skill. A campaign of Zinc-10 was created and tested to promote the concept of 10 days of adherence to zinc; additional visual aids focused on showing dissolving of zinc on a spoon. These candidate concepts and messages were highly accepted by caregivers and providers, yet revisions were needed for images and materials used. Using a social-marketing approach, packaging and promotional messages were developed that were more acceptable to caregivers.