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 - Toukou Souleymane, Hassane

AU - Yacouba, Diagana

AU - Diagana, Moussa

AU - Dougnon, Abdias Ogobara

AU - Vargas, Antonio

AU - Briend, André

N1 - CURIS 2021 NEXS 378

PY - 2021

Y1 - 2021

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 - Faculty of Science

KW - Severe Acute Malnutrition (SAM)

KW - Community Health Workers (CHW)

KW - Integrated Community Case Management (iCCM)

KW - Mid-upper arm circumference (MUAC)

KW - Coverage

U2 - 10.3390/children8121132

DO - 10.3390/children8121132

M3 - Journal article

C2 - 34943328

VL - 8

JO - Children

JF - Children

SN - 2227-9067

IS - 12

M1 - 1132

ER -