Barriers to use of oral rehydration salts for child diarrhea in the private sector: evidence from India

J Trop Pediatr. 2015 Feb;61(1):37-43. doi: 10.1093/tropej/fmu063. Epub 2014 Nov 10.


Diarrhea is the second leading cause of child mortality in India. Most deaths are cheaply preventable with the use of oral rehydration salts (ORS), yet many health providers still fail to provide ORS to children seeking diarrheal care. In this study, we use survey data to assess whether children visiting private providers for diarrheal care were less likely to use ORS than those visiting public providers. Results suggest that children who visited private providers were 9.5 percentage points less likely to have used ORS than those who visited public providers (95% CI 5-14). We complimented these results with in-depth interviews of 21 public and 17 private doctors in Gujarat, India, assessing potential drivers of public-private disparities in ORS use. Interview results suggested that lack of direct medication dispensing in the private sector might be a key barrier to ORS use in the private sector.

Keywords: India; ORS; ORT; child diarrhea; child health; global health; private sector.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Child
  • Diarrhea / epidemiology
  • Diarrhea / therapy*
  • Female
  • Fluid Therapy / methods*
  • Health Care Surveys
  • Hospitals, Private
  • Hospitals, Proprietary
  • Hospitals, Public
  • Humans
  • India
  • Interviews as Topic
  • Male
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Private Sector*
  • Public Sector*
  • Salts
  • Socioeconomic Factors


  • Salts