Title : A school-based health program education significantly increases use of Oral Rehydration Solution (ORS)
Abstract:
The use of Oral Rehydration Solution (ORS) is a proven, low-cost, and life-saving response to diarrheal illness that has long remained underutilized. In Sub-Saharan Africa, the rate of ORS use is under 38%. In poor and rural households, challenges to ORS use include lack of both access and knowledge about how to prepare ORS. This abstract evaluates whether educators trained as school health officers (SHOs) can improve ORS utilization and expand community awareness of practical ORS protocols in low-resource school settings in Kenya. An 18-month evaluation was conducted across 43 schools who participated in a multi-component school health training program in extremely vulnerable areas of Kajiado and Nairobi counties. 191 teachers were trained on diarrhea, dehydration, standardized ORS protocols, zinc, and caregiver education. After a demonstration, SHOs were supervised as they made their own ORS using a simple sugar and salt recipe. Participants then drank their home-made ORS together. Schools submitted structured reports at 6, 12, and 18 months post-training, with baseline data collected retrospectively at month six. The increase in use of ORS was highly significant, with a large effect size. Compared to 0% at baseline, at 18 months 78% of schools reported that they administered ORS at school “frequently or always” when a student was dehydrated and/or had diarrhea. 100% of schools had provided ORS at least once, with a minimum of 647 documented uses across the 43 schools over 12 months. Adherence to evidence-based protocols was high, with 67% of schools referencing guidance “frequently or always” at 18 months. SHOs also extended this knowledge to families. Parent education on ORS use increased from 30% of schools at baseline to 97% at 18 months, with over 403 documented education interactions. Educators trained as SHOs enabled the practical, sustained use of ORS while expanding health literacy among students and families. School-based ORS education and delivery represents a feasible and scalable global strategy to improve early dehydration management and dramatically expand the acceptance and utilization of this critically important therapy.
