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Exploration of Barriers to the Recommendation of Oral Rehydration Salts and Zinc Tablets for Acute Diarrhoea by Patent Medicine Vendors in Lagos State, Nigeria.

Background: Diarrhoea has remained a global burden and leading cause of morbidity and mortality among under-five children especially in low and middle-income countries in spite of availability of oral rehydration salts and zinc tablets (ORS/Zn,), which are the proven and recommended treatments. This persistent global burden indicates possible barriers in the prescription, recommendation or use of ORS/Zn among stakeholders. Objective: This study explored the factors that act as barriers to the recommendation of ORS/Zn in the management of childhood acute watery diarrhoea (AWD) by Patent and Proprietary Medicine Vendors (PPMVs) License holders in Lagos State. Methods: A qualitative study carried out through interviews of PPMVs. A purposive recruitment of 24 PPMVs was done with 18 of them finally participating in the study. Thematic analysis through peer coding was employed to extract the findings of the study presented in themes and subthemes. Results: Three themes associated with barriers to recommending ORS/Zn emerged: rejection of ORS/Zn by parents of children with AWD, misconception about ORS/Zn and difficulties with ORS/Zn preparation. The enhancement of the taste of ORS was the major theme associated with factors that could facilitate recommendation of ORS/Zn. Conclusion: This study revealed that PPMVs knew that they should recommend ORS/Zn for AWD but encountered barriers such as rejection of ORS/Zn by parents, misconception of ORS/Zn and difficulties in the preparation of ORS. They opined that enhancement of the taste of ORS may facilitate acceptance by parents.