Objectives: Diarrhea remains a leading cause of morbidity and mortality for children in low- and middle-income countries throughout the Americas. WHO guidelines have been developed to incorporate zinc supplementation (ZS) with traditional oral rehydration therapy (ORT) to shorten duration and reduce poor health outcomes. Guatemala adopted these guidelines in 2011, but they have not yet been fully implemented at the community level. The objectives of this study were to co-design an ORT/ZS training program with community health promoters appropriate to the local context and to understand how training with the promoters changes attitudes and behaviors of community members.
Methods: In an observational study, community health promoters were trained in rural Guatemala according to WHO guidelines and collaboratively developed training curriculum to implement in their community. Community-based surveys, interviews, and focus group discussions were used to assess acceptability, accessibility, and availability of oral rehydration therapy and zinc supplementation
