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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 principales: Charle-Cuéllar, Pilar, Lopez-Ejeda, Noemí, Toukou Souleymane, Hassane, Yacouba, Diagana, Diagana, Moussa, Dougnon, Abdias Ogobara, Vargas, Antonio, Briend, André
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700149/
https://www.ncbi.nlm.nih.gov/pubmed/34943328
http://dx.doi.org/10.3390/children8121132
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author Charle-Cuéllar, Pilar
Lopez-Ejeda, Noemí
Toukou Souleymane, Hassane
Yacouba, Diagana
Diagana, Moussa
Dougnon, Abdias Ogobara
Vargas, Antonio
Briend, André
author_facet Charle-Cuéllar, Pilar
Lopez-Ejeda, Noemí
Toukou Souleymane, Hassane
Yacouba, Diagana
Diagana, Moussa
Dougnon, Abdias Ogobara
Vargas, Antonio
Briend, André
author_sort Charle-Cuéllar, Pilar
collection PubMed
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.
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spelling pubmed-87001492021-12-24 Effectiveness and Coverage of Treatment for Severe Acute Malnutrition Delivered by Community Health Workers in the Guidimakha Region, Mauritania Charle-Cuéllar, Pilar Lopez-Ejeda, Noemí Toukou Souleymane, Hassane Yacouba, Diagana Diagana, Moussa Dougnon, Abdias Ogobara Vargas, Antonio Briend, André Children (Basel) Article 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. MDPI 2021-12-04 /pmc/articles/PMC8700149/ /pubmed/34943328 http://dx.doi.org/10.3390/children8121132 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Charle-Cuéllar, Pilar
Lopez-Ejeda, Noemí
Toukou Souleymane, Hassane
Yacouba, Diagana
Diagana, Moussa
Dougnon, Abdias Ogobara
Vargas, Antonio
Briend, André
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
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_short 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700149/
https://www.ncbi.nlm.nih.gov/pubmed/34943328
http://dx.doi.org/10.3390/children8121132
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