Enhancing Community Use of Zinc and ORS to Manage Childhood Diarrhea in Afghanistan

Speeches Shim

  • Duration: 
    July 2015 - June 2020
  • Value: $13 Million


Diarrhea is the second leading cause of death among children under five worldwide. Most diarrhea-related deaths in children are due to dehydration from loss of large quantities of body fluids and electrolytes. Management of diarrhea, either through oral rehydration salts (ORS) or a appropriate home fluids (e.g., breastmilk, rice water, plain water, sugar-salt solution (SSS), etc.) can prevent many of these deaths. Since 2003, childhood diarrhea cases have been treated as part of the Afghan Basic Package of Health Services. However, the 2015 Afghanistan Demographic and Health Survey (AfDHS) revealed that less than half of children with diarrhea received treatment with ORS, and only 10 percent received zinc.

USAID, in collaboration with the Government of Afghanistan and UNICEF, launched the zinc and ORS program to improve the quality of diarrhea prevention and treatment in existing health facilities and expand access to Oral Rehydration Salts and zinc at the community level. A reduction in frequency of diarrheal episodes accompanied by a declining percentage of diarrheal deaths (case fatality rate) will help to reduce morbidity and mortality among children under five.


  • Build capacity for appropriate management of diarrheal diseases among community health workers, midwives, nurses, and doctors at primary health care levels
  • Improve the knowledge and care practices among the community and caregivers for improved prevention and management of diarrhea using zinc and ORS
  • Increase community access to diarrhea management services (zinc and ORS) through Community Health Workers


  • Procured and distributed zinc/ ORS co-packs to 14,000 health posts across the country and enabled Community Health Workers to treat 1.1 million children under five years of age annually
  • Developed community-based diarrhea management protocols and training packages
  • 25,000 Community Health Workers and 2,000 health facility staff received training on proper diarrhea case management with zinc and ORS
  • Messages reached 70 percent of the population during an awareness campaign. The campaign included broadcast of mass media (TV and radio) messages, social media activities, dissemination of posters and flip charts, story books in schools, and providing information to journalists
  • Supported the social marketing program of the Afghanistan Social Marketing Organization for simultaneous introduction and scale-up of the ORS/zinc co-pack in the private sector


    Last updated: September 05, 2019

    Share This Page