22. Community based management of severe acute malnutrition

2015 ◽  
pp. 379-392
Author(s):  
R. Jayatissa
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Community Based

scholarly journals Coverage Assessment For Community-Based Management Of Acute Malnutrition In Rural And Urban Ghana: A Comparative Cross-Sectional Study. 

2021 ◽  
Author(s):  
Joana Apenkwa ◽  
Sam K Newton ◽  
Samuel Kofi Amponsah ◽  
Reuben Osei-Antwi ◽  
Emmanuel Nakua ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Qualitative Approach ◽  
Rural District ◽  
Urban Setting ◽  
Acute Malnutrition ◽  
Rural Setting ◽  
Community Based ◽  
Cross Sectional ◽  
Study District ◽  
Point Coverage

Abstract Background: Ghana for years has implemented the Community-based Management of Acute Malnutrition (CMAM) among children in order to reduce malnutrition prevalence. However, the prevalence of malnutrition remains high. This study aimed to determine CMAM coverage levels in the Ahafo Ano South (AAS), a rural district, and Kumasi Subin sub-metropolis (KSSM), an urban district. Methods: The study was a cross-sectional comparative study with a mixed-methods approach. In all, 497 mother/caregiver and child under-five pairs were surveyed using a quantitative approach while qualitative methods were used to study 25 service providers and 40 mother/ caregivers who did not participate in the quantitative survey. Four types of coverage indicators were assessed: point coverage (defined as the number of Severe Acute Malnutrition cases [SAM] in treatment divided by total number of Severe Acute Malnutrition cases in the study district), geographical coverage (defined as total number of health facilities delivering treatment for SAM divided by total number of healthcare facilities in the study district), and treatment coverage (defined as children with SAM receiving therapeutic care divided by total number of SAM children in the study district) and program coverage (defined as number of SAM cases in the CMAM programme ÷ Number of SAM cases that should be in the programme). The qualitative approach was used to support the assessment of the coverage indicators. Data were analyzed using STATA version 14, and Atlas.ti, version 7.5 for the quantitative and qualitative data respectivelyResults: Geographically, only 6% of the facilities in the urban communities were participating in the CMAM programme as against 29% of rural district facilities. The districts had point coverage of 41% and 10% for the urban and rural districts respectively. The urban setting recorded a SAM prevalence of 52% as against 36% in the rural setting. The proportion of SAM children enrolled in CMAM was higher in KSSM when compared with AAS; 41% and 33% respectively. In both districts, the most likely factors to attract mothers/caregivers to utilize the CMAM services were: ‘free services’ and ‘a cured child.’ The qualitative approach showed that coverage improvement in both districts is hampered by barriers such: distance, transportation cost, lack of trained personnel in the communities for community mobilization and home visits, and insufficient feeds. Conclusion: To improve CMAM coverage, there is the need to train health workers to embark on aggressive health education strategies to encourage mothers/caregivers of malnourished children to utilize CMAM while ensuring that services reach those who need them. Trial registration: This study is approved and registered with The Kwame Nkrumah University of Science and Technology Committee on Human Research, Ethics and Publications (CHRPE/AP/314/15)

Improving the outcome of severe acute malnutrition by community-based management

2016 ◽  
Vol 3 (1) ◽  
pp. 20 ◽  
Author(s):  
ZubaidaLadan Farouk ◽  
GarbaDayyabu Gwarzo ◽  
Aisha Zango ◽  
Halima Abdu
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Community Based

scholarly journals Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case–control study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017084 ◽  
Author(s):  
Nilesh Kumar Pravana ◽  
Suneel Piryani ◽  
Surendra Prasad Chaurasiya ◽  
Rasmila Kawan ◽  
Ram Krishna Thapa ◽  
...  
Keyword(s):  
Educational Level ◽  
Case Control Study ◽  
Complementary Feeding ◽  
Severe Acute Malnutrition ◽  
Case Control ◽  
Acute Malnutrition ◽  
Community Based ◽  
Mother’S Age ◽  
Age At Birth ◽  
Control Study

BackgroundMalnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like Nepal. Children with severe acute malnutrition (SAM) are nine times more likely to die than children without malnutrition. The prevalence of SAM has increased in Nepal over the past 15 years; however, the determinants of SAM have not been clearly assessed in the country.ObjectiveTo assess the determinants of SAM among children aged 6–59 months in the Bara district of Nepal.SettingA community-based case–control study was conducted in 12 randomly selected Village Development Committees (VDCs) of the Bara district of Nepal.ParticipantsA random sample of 292 children aged 6–59 months (146 as cases and 146 as controls) from 12 VDCs were included in this study.ResultsThe prevalence of SAM among children under the age of 5 years was 4.14%. The following factors were significantly associated with SAM: low socioeconomic status (adjusted odds ratio (AOR) 17.13, 95% CI 5.85 to 50.13); mother’s age at birth <20 or >35 years (AOR 3.21, 95% CI 1.30 to 7.94); birth interval <24 months (AOR 4.09, 95% CI 1.87 to 8.97); illiterate father (AOR 3.65, 95% CI 1.62 to 8.20); bottle feeding (AOR 2.19, 95% CI 1.73 to 12.03); and not initiating complementary feeding at the age of 6 months (AOR 2.91, 95% CI 1.73 to 12.03). Mother’s educational level, initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM.ConclusionThe mother's age at birth, birth interval, socioeconomic status, father’s educational level and initiation of complementary feeding at the age of 6 months were important determinants of SAM among children. A multi-sector approach is essential to address SAM. There is a need for further studies not only focusing on SAM but also moderate acute malnutrition.

scholarly journals Lessons Learned from Community-based Management of Acute Malnutrition (CMAM) Programmes that Operate in Fragile or Conflict Affected Settings

2021 ◽  
Author(s):  
Evert-jan Quak
Keyword(s):  
Health System ◽  
Local Governments ◽  
Severe Acute Malnutrition ◽  
Lessons Learned ◽  
Childhood Development ◽  
Acute Malnutrition ◽  
Rapid Review ◽  
Surveillance Systems ◽  
Low Literacy ◽  
Community Based

This rapid review synthesises the literature on how community-based management of acute malnutrition (CMAM) programmes could be adapted in settings of conflict and fragility. It identifies multiple factors affecting the quality and effectiveness of CMAM services including the health system, community engagement and linkages with other programmes, including education, sanitation, and early childhood development. Family MUAC (Mid-Upper Arm Circumference) is a useful tool to increase community participation and detect early cases of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) more effectively and less likely to require inpatient care. The literature does not say a lot about m-Health solutions (using mobile devises and applications) in data collection and surveillance systems. Many of the above-mentioned issues are relevant for CMAM programmes in settings of non-emergency, emergency, conflict and fragility. However, there are special circumstance in conflict and fragile settings that need adaptation and simplification of the standard protocols. Because of a broken or partly broken health system in settings of conflict and fragility, local governments are not able to fund access to adequate inpatient and outpatient treatment centres. NGOs and humanitarian agencies are often able to set up stand-alone outpatient therapeutic programmes or mobile centres in the most affected regions. The training of community health volunteers (CHVs) is important and implementing Family MUAC. Importantly, research shows that: Low literacy of CHVs is not a problem to achieve good nutritional outcomes as long as protocols are simplified. Combined/simplified protocols are not inferior to standard protocols. However, due to complexities and low funding, treatment is focused on SAM and availability for children with MAM is far less prioritised, until they deteriorate to SAM. There is widespread confusion about combined/simplified protocol terminology and content, because there is no coherence at the global level.

Are innovative ready to use therapeutic foods more effective, accessible and cost-efficient than conventional formulations? A review

2020 ◽  
Vol 49 (4) ◽  
pp. 267-277
Author(s):  
Lisa F. Clark
Keyword(s):  
Severe Acute Malnutrition ◽  
Food Assistance ◽  
Infants And Children ◽  
Acute Malnutrition ◽  
Community Based ◽  
Track Record ◽  
The World ◽  
Cost Efficient ◽  
In Infants And Children

Ready to Use Therapeutic Foods (RUTFs) are used in international food assistance strategies as a safe and effective way of treating children suffering from severe acute malnutrition (SAM). Though the peanut-based formulation has a proven track record in terms of efficacy in treating SAM around the world, the conventional formulation is not without challenges. Concerns regarding cost, the availability of local ingredients, the presence of aflatoxin, shifting global supply patterns, and dietary appropriateness of the peanut-based RUTF have encouraged researchers to experiment with other lipid sources in formulations. This shift requires not only changes to RUTF formulations, but also changes to supply chain activities. The goal of this review is to first, provide an update on the efficacy of recently trialed non-peanut RUTF formulations in treating SAM in infants and children and second, to review recent UN agency led interventions into local/regional RUTF supply chains and programmatic capacity. Based on published documents (2017–2019), this review flags three significant issues requiring further attention from the international food assistance community: the need for follow-up studies of children treated for SAM with RUTFs in programmatic countries, a regional customization of Community-Based Management of Acute Malnutrition (CMAM) protocols to maximize cost effectiveness and programmatic coverage, and an increase in the number of studies focusing on the acceptability of non-peanut RUTF formulations by the infants and children in low and medium income countries.

Severe acute malnutrition

2008 ◽  
Vol 297 ◽  
pp. 1-3
Keyword(s):  
Public Health ◽  
Medical Treatment ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Community Based ◽  
Case Mortality

In a nutshellIntensive medical treatment of severe acute malnutrition can substantially reduce case mortality from the 30% to the 4% range.However, community-based management using fortified ready-to-eat foods for all but the most severe cases offers a better overall public health solution.

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