TY - JOUR
T1 - Effectiveness and coverage of treatment for severe acute malnutrition delivered by community health workers in the Guidimakha region, Mauritania
AU - Charle-Cuéllar, Pilar
AU - Lopez-Ejeda, Noemí
AU - Souleymane, Hassane Toukou
AU - Yacouba, Diagana
AU - Diagana, Moussa
AU - Dougnon, Abdias Ogobara
AU - Vargas, Antonio
AU - Briend, André
N1 - Funding Information:
Funding: All the actions in the field, were supported by funds coming from U.S. Agency for International Development. Salaries of corresponding was co funded by Action against Hunger.
Funding Information:
All the actions in the field, were supported by funds coming from U.S. Agency for International Development. Salaries of corresponding was co funded by Action against Hunger. Authors would like to thank all partners who contributed to this study, Nouakchott University, Ministry of Health of Mauritania, and all the organizations of the Technical Advisory Group. Our thanks to all the mothers of the children who participated in the study for their time, to the community health workers for their work, to the community leaders and community women's groups for their involvement, to the health personnel of the Ministry in Guidimakha Region for their support, to the entire Action Against Hunger team of Mauritania mission for their commitment with this intervention.
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Community health workers (CHW)
KW - Coverage
KW - Integrated community case management (iCCM)
KW - Mid-upper arm circumference (MUAC)
KW - Severe acute malnutrition (SAM)
U2 - 10.3390/children8121132
DO - 10.3390/children8121132
M3 - Article
AN - SCOPUS:85121817423
SN - 2227-9067
VL - 8
JO - Children
JF - Children
IS - 12
M1 - 1132
ER -
