Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania

Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by commun...

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Autores: Charle Cuéllar, Pilar, López Ejeda, Noemí, Toukou Souleymane, Hassane, Yacouba, Diagana, Diagana, Moussa, Dougnon, Abdias Ogobara, Vargas, Antonio, Briend, André
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/4940
Acceso en línea:https://hdl.handle.net/20.500.14352/4940
Access Level:acceso abierto
Palabra clave:613.24-053.2(661.2)
364.692-056.253
Severe acute malnutrition (SAM)
Community health workers (CHW)
Integrated community case management (iCCM)
Mid-upper arm circumference (MUAC)
Coverage
Dietética y nutrición (Farmacia)
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spelling Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, MauritaniaCharle Cuéllar, PilarLópez Ejeda, NoemíToukou Souleymane, HassaneYacouba, DiaganaDiagana, MoussaDougnon, Abdias OgobaraVargas, AntonioBriend, André613.24-053.2(661.2)364.692-056.253Severe acute malnutrition (SAM)Community health workers (CHW)Integrated community case management (iCCM)Mid-upper arm circumference (MUAC)CoverageDietética y nutrición (Farmacia)Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by community health workers (CHWs) in the Guidimakha region in Mauritania, compared to the HF based approach. This study was a nonrandomized controlled trial, including two rural areas. The control group received outpatient treatment for uncomplicated SAM from HF, whilst the intervention group received outpatient treatment for uncomplicated SAM from HF or CHWs. A total of 869 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 82.3% in the control group, and 76.4% in the intervention group, we found no significant difference between the groups. Coverage in the intervention zone increased from 53.6% to 71.7%. In contrast, coverage remained at approximately 44% in the control zone from baseline to end-line. This study is the first to demonstrate in Mauritania that the decentralization model of CHWs treating SAM improves acute malnutrition treatment coverage and complies with the international quality standards for community treatment of acute malnutrition. The non-randomized study design may limit the quality of the evidence, but these results could be used by political decision-makers as a first step in revising the protocol for acute malnutrition management.MDPIUniversidad Complutense de Madrid20212021-01-0120212021-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/4940reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución 3.0 Españahttps://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/49402026-06-02T12:44:21Z
dc.title.none.fl_str_mv Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
title Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
spellingShingle Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
Charle Cuéllar, Pilar
613.24-053.2(661.2)
364.692-056.253
Severe acute malnutrition (SAM)
Community health workers (CHW)
Integrated community case management (iCCM)
Mid-upper arm circumference (MUAC)
Coverage
Dietética y nutrición (Farmacia)
title_short Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
title_full Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
title_fullStr Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
title_full_unstemmed Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
title_sort Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha Region, Mauritania
dc.creator.none.fl_str_mv Charle Cuéllar, Pilar
López Ejeda, Noemí
Toukou Souleymane, Hassane
Yacouba, Diagana
Diagana, Moussa
Dougnon, Abdias Ogobara
Vargas, Antonio
Briend, André
author Charle Cuéllar, Pilar
author_facet Charle Cuéllar, Pilar
López Ejeda, Noemí
Toukou Souleymane, Hassane
Yacouba, Diagana
Diagana, Moussa
Dougnon, Abdias Ogobara
Vargas, Antonio
Briend, André
author_role author
author2 López Ejeda, Noemí
Toukou Souleymane, Hassane
Yacouba, Diagana
Diagana, Moussa
Dougnon, Abdias Ogobara
Vargas, Antonio
Briend, André
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 613.24-053.2(661.2)
364.692-056.253
Severe acute malnutrition (SAM)
Community health workers (CHW)
Integrated community case management (iCCM)
Mid-upper arm circumference (MUAC)
Coverage
Dietética y nutrición (Farmacia)
topic 613.24-053.2(661.2)
364.692-056.253
Severe acute malnutrition (SAM)
Community health workers (CHW)
Integrated community case management (iCCM)
Mid-upper arm circumference (MUAC)
Coverage
Dietética y nutrición (Farmacia)
description Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by community health workers (CHWs) in the Guidimakha region in Mauritania, compared to the HF based approach. This study was a nonrandomized controlled trial, including two rural areas. The control group received outpatient treatment for uncomplicated SAM from HF, whilst the intervention group received outpatient treatment for uncomplicated SAM from HF or CHWs. A total of 869 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 82.3% in the control group, and 76.4% in the intervention group, we found no significant difference between the groups. Coverage in the intervention zone increased from 53.6% to 71.7%. In contrast, coverage remained at approximately 44% in the control zone from baseline to end-line. This study is the first to demonstrate in Mauritania that the decentralization model of CHWs treating SAM improves acute malnutrition treatment coverage and complies with the international quality standards for community treatment of acute malnutrition. The non-randomized study design may limit the quality of the evidence, but these results could be used by political decision-makers as a first step in revising the protocol for acute malnutrition management.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/4940
url https://hdl.handle.net/20.500.14352/4940
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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