Menu ENN Search

Integration of severe acute malnutrition treatment in primary health care provided by community health workers in rural Niger

View this article as a pdf

Lisez cet article en français ici

This is a summary of the following paper: Ogobara Dougnon A, Charle-Cuéllar P, Toure F (2021). Impact of integration of severe acute malnutrition treatment in primary health care provided by community health workers in rural Niger. Nutrients, 13(11). Available at: https://doi.org/10.3390/nu13114067

In Niger, childhood malnutrition remains a public health problem. In the Maradi region, the prevalence of global acute malnutrition (GAM) reached 11.4% with 3.4% severe acute malnutrition (SAM) in the same year. Niger’s community-based management of acute malnutrition (CMAM) policy dictates that SAM be treated by nurses in health facilities. However, the integration of SAM treatment into integrated community case management platforms has the potential to increase coverage through the community-based treatment of uncomplicated SAM cases by community health workers (CHWs). In parallel, there has been increased interest in simplified protocols for SAM treatment including the use of mid-upper arm circumference (MUAC) as a single criterion for treatment admission.

This study aimed to assess the impact of the integrated management of SAM by CHWs on treatment coverage in the Maradi region of Niger, with special attention given to anthropometric criteria for admission to treatment. A non-randomised controlled trial was implemented in two rural communes, Maïreyreye (control) and Guidan Amoumoune (intervention). The control group received outpatient treatment for uncomplicated SAM from health facilities while the intervention group received outpatient treatment from health facilities or CHWs. A total of 2,789 children aged 6–59 months were included in the study.

Results showed that the addition of CHWs as service-providers increased treatment coverage and CHWs maintained a good quality of care. In the intervention area, coverage increased by 3.1% and 77.2% of children were cured, compared to the control area where coverage decreased by 8.3% and 72.1% (below Sphere standard) were cured. Children managed by CHWs had a less severe anthropometric condition at admission and recovered seven days earlier than those treated exclusively at health facilities. In addition, a higher proportion of children admitted to treatment were identified by MUAC (33.9%) compared to weight-for-height z-score (12.1%) as the sole criterion. Expanding the MUAC cut-off to 125 mm as an admission criterion also allowed for almost all (99.5%) children identified by weight-for-height z-score to be admitted for treatment. These findings support a potential revision to Niger’s protocols for the management of acute malnutrition to incorporate community-based management by CHWs.  

More like this

FEX: Management of severe acute malnutrition by community health workers: Early results of Action Against Hunger research

View this article as a pdf Lisez cet article en français ici By Pilar Charle-Cuellar, Noemi Lopez-Ejeda, Magloire Bunkembo, Abdias Ogobara Dougnon and Hassane Toukou...

FEX: Community health worker-led treatment for uncomplicated wasting: insights from the RISE study

View this article as a pdf Lisez cet article en français ici By Bethany Marron on behalf of the RISE study consortium Bethany Marron is a nutrition advisor and former...

FEX: ComPAS trial in South Sudan and Kenya: Headline findings and experiences

View this article as a pdf Lisez cet article en français ici By Bethany Marron, Pamela Onyo, Eunice N Musyoki, Susan Were Adongo and Jeanette Bailey Bethany Marron is...

FEX: Management of acute malnutrition in Niger: a countrywide programme

By Dr Guero H Doudou Maimouna, Dr Yami Chegou and Prof Ategbo Eric-Alain Dr Guero H Doudou Maimouna is a Paediatrician and holds a PhD in Public Health. She has over 15 years...

en-net: Where is MUAC used as the only admission criteria for SAM treatment programmes?

The CMAM Forum is currently mapping out all programmes where MUAC is used as the only admission criteria for SAM treatment, along with bilateral pitting oedema (as opposed to...

FEX: A series of three related published papers share findings regarding quality of care, treatment outcomes and cost-effectiveness of uncomplicated SAM treatment delivered by community health workers (CHWs) in rural Mali.

By Eleanor Rogers, Karen Martínez, Jose Luis Alvarez Morán, Franck G. B. Alé, Pilar Charle, Saul Guerrero, Natalie Sessions and Chloe Puett Quality of...

FEX: Community health worker-led treatment for uncomplicated wasting: insights from the RISE study

This is a summary of a Field Exchange field article that was included in issue 64. The original article was authored by Bethany Marron on behalf of the RISE study...

FEX: Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Nigeria

View this article as a pdf Research snapshot1 Treatment programmes for severe acute malnutrition (SAM) tend to focus on initial recovery with limited evidence on post...

FEX: In Chad, the Mother-MUAC approach improves treatment access for malnourished children

View this article as a pdf Lisez cet article en français ici By Hyppolite Gnamien, Chantal Autotte Bouchard, Jean-Robert Bwanaissa Shabani, Emily Helary and Marion...

FEX: Community case management of severe acute malnutrition in southern Bangladesh

Summary of study1 Bangladesh has the fourth-highest number of children (approximately 600,000 at any one time) suffering from severe acute malnutrition (SAM) in the world....

FEX: Management of moderate acute malnutrition with RUTF in Niger

Isabelle Defourny and Géza Harczi By Isabelle Defourny, Gwenola Seroux, Issaley Abdelkader, and Géza Harczi Isabelle Defourny is Deputy Desk Manager, MSF-France, Paris Géza...

FEX: MUAC as discharge criterion and weight gain in malnourished children

Summary of published research1 A child on admission to the Gedaref nutrition programme In addition to guidance on admission criteria for nutrition programmes, the WHO...

FEX: Adaptations to community-based acute malnutrition treatment during the COVID-19 pandemic

View this article as a pdf Lisez cet article en français ici By Maria Wrabel, Sarah King and Heather Stobaugh Maria Wrabel is CMAM Adaptations Project Officer with...

FEX: Simplifying the response to childhood malnutrition: MSF’s experience with MUAC-based (and oedema) programming

By Kevin P.Q. Phelan, Candelaria Lanusse, Saskia van der Kam, Pascale Delchevalerie, Nathalie Avril and Kerstin Hanson Kevin P.Q. Phelan was the Nutrition Working Group Leader...

en-net: Simplified Approaches in the context of COVID 19 (questions escalated to the GTAM Wasting TWG)

a. What can we do to quickly communicate that this [simplified approaches] is an acceptable adaptation to make in the circumstances to enable governments to make this...

FEX: Scaling up the treatment of acute childhood malnutrition in Niger

Milton Tectonidis By Isabelle Defourny, Emmanuel Drouhin, Mego Terzian, Mercedes Tatay, Johanne Sekkenes and Milton Tectonidis Emmanuel Drouhin is the Niger Desk Officer,...

FEX: Enabling low-literacy community health workers to treat uncomplicated SAM as part of community case management: innovation and field tests

By Casie Tesfai, Bethany Marron, Anna Kim and Irene Makura Casie Tesfai is a Nutrition Technical Advisor at the International Rescue Committee in New York, where she provides...

FEX: Use of MUAC by novel community platforms to detect, diagnose and treat severe acute malnutrition

Research snapshot1 There is growing consensus that making mid-upper arm circumference (MUAC) use more widely accessible among caregivers and community health workers (CHWs)...

FEX: Integration of CMAM into routine health services in Nepal

By Regine Kopplow Regine is a former CMAM Advisor with Concern Nepal. She is a nutritionist with a background in rural development. She has worked in the field of nutrition...

en-net: Discharge criteria when using MUAC for admission

Ethiopia has been using the old cut off of 110 mm (11cm) for admission of children with SAM and the discharge was based on target gain as most of the facilities (health posts)...

Close

Reference this page

Integration of severe acute malnutrition treatment in primary health care provided by community health workers in rural Niger. Field Exchange 67, April 2022. p76. www.ennonline.net/fex/67/integrationofsamtreatment

(ENN_7338)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.