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Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali

(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CH...

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Autores principales: Charle-Cuéllar, Pilar, López-Ejeda, Noemí, Traore, Mamadou, Coulibaly, Adama Balla, Landouré, Aly, Diawara, Fatou, Bunkembo, Magloire, Vargas, Antonio, Gil, Ruth, Briend, André
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911749/
https://www.ncbi.nlm.nih.gov/pubmed/33530333
http://dx.doi.org/10.3390/nu13020367
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author Charle-Cuéllar, Pilar
López-Ejeda, Noemí
Traore, Mamadou
Coulibaly, Adama Balla
Landouré, Aly
Diawara, Fatou
Bunkembo, Magloire
Vargas, Antonio
Gil, Ruth
Briend, André
author_facet Charle-Cuéllar, Pilar
López-Ejeda, Noemí
Traore, Mamadou
Coulibaly, Adama Balla
Landouré, Aly
Diawara, Fatou
Bunkembo, Magloire
Vargas, Antonio
Gil, Ruth
Briend, André
author_sort Charle-Cuéllar, Pilar
collection PubMed
description (1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.
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spelling pubmed-79117492021-02-28 Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali Charle-Cuéllar, Pilar López-Ejeda, Noemí Traore, Mamadou Coulibaly, Adama Balla Landouré, Aly Diawara, Fatou Bunkembo, Magloire Vargas, Antonio Gil, Ruth Briend, André Nutrients Article (1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated. MDPI 2021-01-26 /pmc/articles/PMC7911749/ /pubmed/33530333 http://dx.doi.org/10.3390/nu13020367 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Charle-Cuéllar, Pilar
López-Ejeda, Noemí
Traore, Mamadou
Coulibaly, Adama Balla
Landouré, Aly
Diawara, Fatou
Bunkembo, Magloire
Vargas, Antonio
Gil, Ruth
Briend, André
Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali
title Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali
title_full Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali
title_fullStr Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali
title_full_unstemmed Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali
title_short Impact of Different Levels of Supervision on the Recovery of Severely Malnourished Children Treated by Community Health Workers in Mali
title_sort impact of different levels of supervision on the recovery of severely malnourished children treated by community health workers in mali
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911749/
https://www.ncbi.nlm.nih.gov/pubmed/33530333
http://dx.doi.org/10.3390/nu13020367
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