By Zachary Wagner et al.
Source Sicence
Editor’s summary
Diarrhea is a leading cause of child mortality in India. It becomes deadly when excretions exacerbate severe dehydration and loss of electrolytes. Most health care providers in India know that oral rehydration salts (ORS) are an inexpensive, lifesaving treatment for child diarrhea, yet they are widely underused. Wagner et al. undertook randomized controlled trials involving standardized patients (actors trained to seek care for a child’s diarrhea) who visited 2282 private health care providers in India. Trials were designed to identify three barriers driving underutilization: assuming patients lack interest in ORS, incentives to prescribe more lucrative (but inappropriate) medicines, and incentives to sell non-ORS medicines in stock when ORS are unavailable. The dominant barrier was assuming that patients were uninterested, showing that simple interventions could save many lives.