ORS and Zinc Co-Pack Launch in Nepal

Title: ORS and Zinc Co-Pack Launch in Nepal
Principal Investigators: Sujan Karki, Tess Shiras, and Heather Cogswell
Timeline: May 2018 – May 2020


The SHOPS Plus Nepal program is supporting the Nepal CRS Company (CRS), a Nepalese social marketing organization and key USAID partner, to launch an oral rehydration solution (ORS) and zinc co-pack in the private sector to promote appropriate childhood diarrhea case management. CRS currently markets and sells an ORS brand called Nava Jeevan, which is one of the most widely sold brands in the country. CRS leveraged the brand equity of Nava Jeevan to promote the new co-pack. 

SHOPS Plus and CRS launched the product in two distinct areas to develop and test effective commercial approaches and community-based demand creation activities. The first area is in four rural hill districts where CRS implemented integrated community-based social and behavior change campaigns. The second area of implementation was urban Province 2, where CRS was focusing on ensuring commercial viability. Province 2 is in the terai where the population is denser, the roads are better, and commercial infrastructure is stronger. SHOPS Plus worked with CRS to educate pharmacists and chemists about the co-pack and promote it as a better alternative to antibiotics for uncomplicated cases of childhood diarrhea.

To inform the co-pack launch, SHOPS Plus conducted qualitative market research. This research served two purposes: 1) to pre-test the co-pack branding and 2) to better understand caregivers’ diarrhea treatment practices and perceptions to inform key messages for the co-pack marketing campaign. A previous knowledge, attitudes, and practices survey in Nepal found that caregivers had conflicting opinions regarding appropriate diarrhea treatment, so the qualitative research aimed to learn more about why caregivers preferred or used particular treatments. Learn about the qualitative results in this report.  

In addition, SHOPS Plus monitored co-pack availability through a retail outlet survey. This quantitative retail audit documented availability of ORS and zinc in Province 2 before and after CRS launched its new co-pack.


The qualitative market research used 12 focus group discussions with female caregivers of children under five in the four hill districts and in Province 2. The discussions asked participants to compare four different co-pack brand options with different name and packaging variants. In addition, each focus group discussion explored caregivers’ experiences with and perceptions of diarrhea care-seeking and treatment. 

The retail outlet survey used Lot Quality Assurance Sampling to monitor product availability and accessibility. Data collectors gathered information from a sample of health outlets on product availability, frequency of stock outs, and presence of CRS brand promotional materials. Outlets included pharmacies, chemists, general stores, grocery stores, department stores, and other small shops.

Relevant Resources:

Status: Completed
Last updated: October 2020

Learn more about our work in Nepalchild health, and pharmaceutical partnerships and social marketing.

See other SHOPS plus studies. 



Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.

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