Martyn J

Co-founder @ Clear Solutions - non-profit fighting diarrheal disease
116 karmaJoined Jun 2022Working (15+ years)
www.clearsolutions.global

Bio

Participation
3

Co-founder of Clear Solutions, a non-profit focussed on preventing the deaths of young children from diarrhoea, a leading cause of death globally. Incubated by Charity Entrepreneurship, and co-founded with Dr Jun Young (Charlie) Jeong, Clear Solutions operates in Nigeria, increasing access to, and usage of, low-cost highly-effective treatments for diarrhoea, oral rehydration solution (ORS) and zinc.

Previously 15+ years at Google in a variety of technical partnerships and leadership roles.

How others can help me

Support Clear Solutions with your insights, network or donations.

How I can help others

Experience of major impact-oriented career change (Big Tech -> Founding a non-profit). Founding and operating a (small) direct-delivery Global Health non-profit. 

Comments
3

That's good feedback, thanks: we've perhaps leapt too directly from the conceptual description to the results, without properly quantifying the basic operation. Noted for improvement.

To (finally, I hope!) answer your question, of the ~2400 (2381) households surveyed - actually 2163 once we filter-out the non-consents:

  • 1518 (70.1%) reported any occupant using ORS from any source; and
  • 924 (42.7%) reported any occupant using ORS from our distribution.

in the 6 weeks of our follow-up period.

This is "all wards" data, so may skew somewhat according to exact response numbers per ward. Please take these numbers as provisional / subject-to-error in the name of a timely response. 

We have not looked at them in more depth yet, but I see the value in this perspective and we'll think more about what we might learn from them. I'm also interested in your take on what we might infer from these, Nick (and others).

whether 93% - ish of all families given ORS used it over 6 weeks or something different?

Something different :) But I think I see what you’re getting at.

Total distribution was to ~4000 households (families) across the 4 wards. The question on usage by age group of ‘our’ ORS was asked at follow-up, with approx. 2400 HHs surveyed.  Of the ORS sachets used by HHs in that sample, the data in the table “% Clear Solutions ORS sachets used, % by age group” expresses who (by age group) used them.

I think you’re asking what proportion of all the ORS provided was used (1) by anyone, and (2) by under-5s. This is a good point, as it gives an idea of what revisit cadence, or potential increase in packets given-per-child, would be needed for continuous coverage.

Said sample of HHs reported 3317 co-packs received (ie. 6634 ORS sachets, 2 per co-pack), with 2046 sachets reported used (with ~80%, varying by ward, used for under-5s). So 2046/6634 = 30.8% of the ORS sachets distributed were reported used within the 6-week follow-up period. We'll prep this also for addition to the report - thank you!

Hi Nick, thanks for sharing your thoughts and excellent points.

Regarding the urban slum rates, thank you for calling this out! On digging back into it, we realise we unfortunately missed copy-pasting corrected prevalence data into the report when we fixed a code bug for urban slum Baseline (which initially included diarrhoea instances for an additional week for both timeframes). The other wards used a later survey version with separate logic and are not impacted. The pre-post results data in the report were updated after the fix, so no change needed there.

That all said, the corrected urban slum Baseline 2-week and 4-week prevalences of 30.1% and 41.8% (will update original post) are still comparatively high.

Regarding the proportion of all distributed ORS that was used, we asked households how many ORS sachets they used by age-group for the 6-week follow-up period and counted how many sachets they had left, so we do have those extra signals with which to scrutinise their claimed ORS treatment rates. A complicator here is the unknown volume of ORS used in a given treatment; 2 x one litre sachets are provided per co-pack, but one litre can be sufficient depending on the diarrhoea duration and whether the caregiver abides by the instruction to discard prepared ORS after 24 hours. Nonetheless, this is certainly something for us to look into further. 

Thanks again for your thoughtful comments and for helping improve our program!