Under the auspices of Integrated Management of Childhood Illnesses (IMCI), Directorate General of Health Services (DGHS) and the SUZY Project of ICDDR,B organized an orientation and information sharing session in ICDDR,B, Dhaka. It was a series of half-day sessions for front line healthcare managers of the public health sector in districts and ’upazilas’ (sub-districts) on zinc treatment for young children with diarrhoea in Bangladesh. All the civil surgeons, who act as the focal points of the districts, and upazila health and family planning officers (UH&FPOs), who act as the focal points at the sub-district level, were included as participants in the orientation programme. The divisional directors were also invited in the programme.

 

In Bangladesh, there are 464 UH&FPOs, 64 civil surgeons and 6 divisional directors in the public health sector. The programme was conducted over nine days between May 31 and June 13, 2007 to include all the public health sector health managers in different sessions. 

 

The Director General of DGHS inaugurated the nine-day programme. From the same department, the Director of primary health care and Line Director, essential services delivery, Programme Manager of child health and Programme Manager of IMCI were present in various sessions to discuss important issues with participants.

 

The sessions comprised an overview and updates of the scale up activities of zinc treatment in Bangladesh, detailed information on its use in childhood diarrhoea and the public sector initiative on management of diarrhoea among under-five children.

 

The liveliest part of the session was the open discussion where the participants ask their questions and interact. They came up with many questions related to use of zinc in diarrhoea, distribution to the public health facilities, and the side effects of zinc. They also shared their thoughts on this type of treatment for childhood diarrhoea. The SUZY Project Head Dr Charles P Larson and Programme Manager of IMCI Dr Altaf Hossain responded to the queries during the open discussion, and Mr Rafiqul Islam, Director (Marketing & Sales) of the ACME Laboratories Limited - the Baby Zinc manufacturer in the country - was also present in some sessions to answer questions.

 

The most frequent queries were:.

- In the Baby Zinc TV commercials, the need for ORS is not highlighted. Would it be possible to put more emphasis on ORS in future campaigns?

- Is it possible to mix zinc in ORS sachet?

- Does zinc work in adult diarrhoea?

- Can zinc be used as preventive medication for diarrhoea?

- What would be the dose for adverse affect of zinc?

- How much time does it take for zinc to be absorbed in the intestine?

- Is it possible to reduce the length of the full course? Will a 5-day course work equally to a 10-day course?

- What are the side effects of zinc? How can they be overcome?

- What is phytate?

 

There were a few more concerns raised in different sessions, such as

- Is it possible to provide dispersible tablets in an airtight bottle instead of blister pack?

- What should be done if a diarrhoea patient is released after three days of hospitalization? Should the patient be given the remaining seven tablets to complete the full course?

- Is it possible to increase zinc in our regular food by adding zinc fertilizer in the soil?