POUZN - Abt Associates / Population Services International

POUZN works globally to mobilize the private sector for the prevention and treatment of diarrhea through the introduction of low-cost point-of-use (POU) water treatment products and zinc. POUZN is a five-year task order, under USAID’s Private Sector Program (PSP) indefinite quantity contract (IQC) awarded in October 2005.

Lack of access to safe drinking water is a reality for more than a billion people in the developing world and contaminated water is one of the leading causes of diarrhea among children. Point-of-use water disinfection that includes chlorine, safe storage and behavior change communication is a proven strategy for reducing diarrheal disease. Field trials have shown a 44-85% reduction in diarrheal episodes when using these products. Point-of-use water treatment programs have been implemented by Population Services International (PSI) in 20 countries and have been found to be affordable, practical and an immediate solution to lack of clean drinking water. When used correctly, a measured capful of dilute sodium hypochlorite or one tablet of disodium disinfects water at point-of-use by inactivating microbial pathogens that cause diarrhea. POUZN promotes the use of both the CDC/PAHO-developed Safe Water System (SWS-a chlorine solution) and Medentech's Aquatabs (a chlorine tablet) for the treatment of household drinking water.

Zinc is a new and cost effective approach for the prevention and treatment of childhood diarrhea. Recently completed effectiveness studies have shown that zinc supplements, taken daily for 10-14 days during a bout of diarrhea, reduces its severity and duration. In addition, zinc supplements have been shown to have a preventive and long-lasting impact, reducing the number of episodes of diarrhea for an additional 2-3 months. For this reason, WHO and UNICEF have recently recommended that children be given zinc supplements, together with Oral Rehydration Salts/Oral Rehydration Therapy (ORS/ORT), for the treatment of acute diarrhea. POUZN promotes the sale and use of both zinc tablets and a diarrhea treatment kit containing both zinc and ORS.

Our goal is to significantly increase the use of point-of-use water treatment and zinc to decrease the incidence of diarrhea in children under five by:

• Introducing and creating sustainable commercial markets for POU water disinfection and zinc products through partnerships with commercial manufacturers and distributors, with accompanying demand creation to build the total market.
• Leveraging our proven track record in registering new products; working with public sector, commercial and NGO counterparts; addressing regulatory issues; establishing national standards for quality assurance; and working in partnership with professional medical associations.
• Ensuring correct and consistent product use through research-driven consumer and provider-focused behavior change communications.
• Ensuring products are accessible and affordable to the poor through effective negotiations with commercial partners, and targeted product subsidies.
• Building on and strengthening existing in-country programs that distribute and sell other public health products, such as ORS or insecticide-treated nets to introduce POU water treatment or zinc products.
• Using social marketing programs to catalyze the commercial market, demonstrating the viability of these products to commercial firms.
• Supporting the growth of local commercial manufacturers by assisting them to develop high quality products and launch their own POU water treatment or zinc brands.

Abt Associates, together with Population Services International, brings extensive experience in implementing social marketing programs and commercial partnerships that result in sustainable national scale programs. PSI has been the leader in the area of point-of-use water treatment through the private sector, launching and supporting the delivery of SWS in the private sector in 20 countries. Together PSI and Abt have in-country expertise in over 60 countries that allows for the rapid and cost effective implementation of POUZN programs.

POUZN field teams are actively implementing zinc treatment programs in three countries. In Benin and Madagascar, POUZN is marketing and promoting the use of diarrhea treatment kits containing both zinc and ORS through both commercial and NGO channels. In Pakistan POUZN is supporting local manufacturers of zinc by funding the development of a demand creation campaign and training providers on the new protocols for management of diarrhea using zinc with ORS/ORT. POUZN’s zinc promotion program in Nepal concluded in 2008. End-of-project research indicated 15% of caregivers were using zinc to treat their children with diarrhea and that exposure to mass media communications was key to improving knowledge about zinc and correct use of zinc. Click here to download the Nepal Research Report. Here is a link to the TV commercial aired in Nepal during POUZN’s campaign.

POUZN teams are also currently implementing point-of-use water disinfection programs in Bangladesh, Benin, Kenya, Malawi, and Rwanda. Recent field research in Rwanda indicated that interpersonal communications were key to increasing knowledge about water treatment and to statistically significant increases in both ever use and correct and consistent use of the product. Field teams are currently conducting survey research studies in Kenya and Benin to evaluate program progress in those countries.

POUZN has also developed a toolkit to help program managers evaluate programs that introduce zinc for the treatment of pediatric diarrheas. Included in the toolkit are both quantitative and qualitative data collection instruments: a questionnaire to collect data from household respondents; focus group guides to be used in discussions with caregivers and community-based sales agents or health workers; and sample questions to be posed in individual interviews with pharmacy personnel and formal or informal sector health care providers. These research instruments have been designed as guides to be adapted to the local conditions of the program being implemented. Click here to download the Toolkit.

Angola, Bangladesh, Benin, Democratic Republic of Congo, Haiti, Kenya, Madagascar, Malawi, Nepal, Pakistan and Rwanda

For country specific information about POU program activities and zinc treatment activities, visit the Where We Work page.

View POUZN-contributed Resources

For further information please contact:

Ms. Susan Mitchell
Director, POUZN / Abt Associates
Tel: 301.347.5124
E-mail: Susan_Mitchell@abtassoc.com

Ms. Vicki MacDonald
Program Manager, POUZN / Abt Associates
Tel: 301.347.5670
E-mail: vicki_macdonald@abtassoc.com

Mr. John Borrazzo
CTO, POUZN / USAID/GH/HIDN/ID
Tel: 202.712.4816
E-mail: jborrazzo@usaid.gov