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Kit Yamoyo: Home treatment for diarrhoea

IN 2013, a British multinational healthcare company and Save the Children, formed a long-term global partnership by combining expertise, resources and influence to help save lives of one million children over five years.
The focus was to develop child-friendly medicines to reduce child mortality and new born deaths.
This culminated into Simon and Jane Berry of ColaLife Zambia being awarded the second Healthcare Innovation Award from GSK and Save the Children worth US$370,000 for designing the Kit Yamoyo, a home treatment for diarrhoea.
Almost 30 years ago, while working in Chinsali in Northern Province, Simon and Jane wondered how Coca-Cola drink was available in all corners of the world including remote areas of developing countries and yet essential and life-saving drugs were not easily accessible.
This prompted the couple to set up Cola-Life Zambia, a UK-based charity to design Kit Yamoyo, which comprises oral rehydration salts (ORS) and Zinc for the home treatment of diarrhoea, to be supplied to remote areas through distribution chains used for Coca-Cola and other fast moving consumer goods.
In 2011, ColaLife partnered with Coca-Cola and began a 12-month trial in Kalomo and Katete where they worked with mothers to design a specially-tailored low cost treatment so that no child dies from diarrhoea.
Simon and Jane discovered that most parents were unaware of the recommended treatment dosage and suitable treatment options for use in the home were not easily available.
“The key thing is that before we started the trial we consulted with mothers and those taking care of sick children to find out the challenges they had the one litre sachet,” Simon explained.
The mothers also choose the name ‘Kit Yamoyo’ and picked a picture of a loving mother and a loving child and not a smiley face for the packaging.
As Simon and Jane consulted with parents they learnt that the one litre sachet had no measuring guide and was not suitable for use in a home as a child would only drink 400ml with 600ml being thrown away; the smaller 200ml sachet helped eliminate waste.
Initially a ‘funny shape’ packaging with the measure was designed to fit into Coca-Cola crates as the beverage was being transported to remote areas but this was later abandoned.
It was discovered that only four percent of retailers stocked the kit on demand from mothers which they sold with other consumer goods at a profit. ColaLife decided to change the packaging to a screw top jar with 200ml mark to make measuring easy.
However, the challenge with the jar was that although it is100 percent Zambian, it was not affordable to intended users, hence Pharmova started producing the treatment in a cheaper zip up packet with a measure guide and could stand by itself.
To create demand, Cola-Life partnered with Keepers Zambia Foundation (KZF) to build partnership with all stakeholders by establishing a private-sector driven chain for the kit. KFZ is a non-governmental organisation that has been working for over 19 years among grassroots in nine provinces.
Executive director John Msimuko said the initial idea was ensure that demand for the kit was created on ground. “We started from the top at the Ministry of Health right down to community health workers and we also identified retailers who were involved in selling other essential goods and over-the-counter drugs like Panadol,” he said.
These retailers were trained to help parents who needed the kit as well as health workers at health facilities and communities for them to have an appreciation and desire for an affordable and accessible remedy for diarrhoea. Once this was done; the demand was in much the same way as Coca Cola operates.
By reaching the remotest areas, demand was created; retailers were able to make a profit as they sold the kit with other consumer goods. This demand in rural communities reduced the distance parents and caregivers have to travel to access the kit.
Before the innovation, over 60 percent mothers or care givers had to cover about 7.3 kilometres to reach the reach nearest health centre. This distance has reduced to 2.4 kilometres on average.
During the trial, 26,000 kits were sold and 45 percent of the children received the ORS/Zinc up from one percent before. The perception of ORS as an effective treatment rose by 48 percent from 78 to 92 percent.
And with the measure guide 93 percent of users were able to mix the ORS correctly compared to 60 percent who were given the one litre sachets.
Pharmova Zambia General manager Alappan Murugappan, manufacturers of the kit said the packaging which is user-friendly has reduced on wastage; mothers are able to treat their children for 3.5 days instead of 2.5 days sachets.
Save the Children Zambia country director Tamer Kirolos spoke on what role partnerships play in serving as a catalyst for tackling issues associated with child mortality although enormous strides have been made to reduce the deaths.
He said in order to bring life-saving healthcare to the vulnerable; there was need for ambitious new ideas and collaborations such as the one between GSK and his organisation.
“There are many things that trigger innovation. For example, community partnerships through the use of traditional birth attendants is vital because although they are trained on ground, they are not entitled to deliver children. Mothers are encouraged to give birth at health facilities,” he said
TBAs are assets in children’s health they can work together with health personnel to reinforce health messages. Save the Children is looking at making use of this resource.
Mr Kirolos said through the recognition and funding from the award, Kit Yamoyo will make a bigger impact, widen vaccine coverage to reduce death in remote areas, research affordable nutritional products to address the needs of children and alleviate malnutrition. It will also increase investment in training, reach and scope of health workers in poorest communities to reduce child mortality.
And GSK vice-president, Africa and Developing Countries Ramil Burden hailed Simon and Jane as being truly inspirational and hoped with the award they will scale-up to make sure more children’s lives are saved.
“There is no point in making vaccines and drugs if children who need them most in sub- Saharan Africa and other developing countries are unable to access them,” he said.
Mr Burden said the innovation clearly demonstrates how effective supply chains can improve access to healthcare even in remote areas and its potential for reproduction ensures that the Kit Yamoyo impact is felt beyond Zambia’s borders.
Speaking at the presentation of the award, Minister of Health Joseph Kasonde said the innovation would bring the anti-diarrhoea treatment closer to rural communities.

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