Diarrhoea is one of the biggest killers of children under five, it is more deadly than HIV-AIDS, malaria, and measles combined. In India one child in every 4 minutes loses its life to diarrhea. Most often, diarrhoea kills children because of severe dehydration. Diarrhoea can be easily treated through oral rehydration therapy (ORS), zinc (as recommended by WHO), and increased intake of fluids.
Our field insights revealed that while most women were aware of ORS and zinc, they weren’t sure how it could help. They didn’t understand the dangers of dehydration and were focused on stopping the diarrhoea as opposed to rehydrating the child.
A doll to visually demonstrate dehydration and diarrhoea
Building on this insight, Shaping Demand and Practices created ‘Pari a plastic doll which aims to bring alive medical facts through demonstration, recognizing that dehydration is a problem not understood by families in Bihar.
The plastic doll is filled up with water by a health worker then water is released through a plug in the doll, representing a baby’s bottom. As water pours out of the doll it shrivels up, demonstrating the dehydration caused by diarrhoea.
The health worker then refills the doll with oral rehydration solution, showing the effects of dehydration being reversed. Demonstrations using the doll create instant demand for life-saving oral rehydration solution and zinc supplementation, transforming these into “must-have, must-use” products.
Design decisions in developing the doll included the choice of materials, inlet-outlet methods, how to control the rate of fluid flow, the shape, packaging, portability and how this would all affect the way that the health worker demonstration looked to audiences. Multiple rounds of testing and iterations were done to get the size, shape and timing of the flow of the water of the doll right.
Is ‘Pari’ (diarrhoea doll) working?
Pari has been evaluated and the results reveal:
Pari has been used in Bihar for over two years across 8 districts at VHSNDs sites and 600 Primary Health Centers (PHC). Recently, the Government of Bihar has committed funds to scale up ‘Pari’ to all 38 districts of Bihar.