Design thinking to improve rational use of oral rehydration salts: lessons from an innovative co-packaged diarrhoea treatment kit

Introduction We explored whether greater consideration of product design, informed by end users’ opinions, led to improved utilisation (ie, rational use) of oral rehydration salts (ORS) in home settings. We tested whether a ‘design thinking’ approach, focusing on product acceptability, functionality and ease of use, contributed to an increased likelihood of appropriate ORS use, specifically dosing and preparation of ORS in the correct concentration. Methods Intervention design decisions were used to develop a co-packaged diarrhoea treatment kit containing ORS and zinc, branded as ‘Kit Yamoyo’. In addition to co-packaging, key product design features were the inclusion of 200 mL ORS sachets and a water measurement function incorporated in the packaging design. Cross-sectional data from household surveys of caregivers in rural Zambia were then used to compare ORS preparation and use for diarrhoea patients aged <5 years, who used either the novel co-pack or standard 1 L sachets of ORS. Design benefits were demonstrated to caregivers from two rural areas by trained community health workers (CHWs). Results Odds of correct ORS preparation were 10.93 times greater (p<0.001; 95% CI 5.74 to 20.78) among Kit Yamoyo users versus individuals who used 1 L sachets. Co-pack users prepared ORS to the correct concentration 93% (95% CI 0.89% to 0.96%) of the time, while non-users prepared it in the correct concentration just 60% (95% CI 0.54% to 0.66%) of the time. Conclusion Application of design thinking to the development of a co-packaged ORS and zinc diarrhoea treatment kit, coupled with demonstrations by CHWs, can improve rational use of ORS.