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Opportunities and barriers in scale-up of Management of small and nutritionally At-risk Infants under six months and their Mothers (MAMI) in four humanitarian settings: a qualitative study.

Author: Astrid Klomp
Year: 2021
Resource type: Report

Introduction: For children to survive and thrive, malnutrition should be prevented and addressed early. There is increasing awareness of the scale and the need among infants u6m, but the uptake of the Management of small or nutritionally At-risk Infants and their Mothers (MAMI) has been slow. This study aims to explore barriers and opportunities to scale-up the MAMI care pathway version 3 within one humanitarian organisation.

Methods: In-depth interviews of health and nutrition staff at different levels within Medair. Thematic analysis was used, and themes were created through the a priori objectives and other themes emerged through inductive analysis.

Results: 11 participants were interviewed representing four humanitarian settings. Participants expressed a need to address and manage infants u6m. Perceived gaps in treatment were high workload for current health and nutrition (h&n) staff and unclear guidance on identification and management of u6m infants. Some technical barriers were the time needed for MAMI assessment and management and the need for mothers to return for frequent facility-based follow-up. An opportunity was seen as implementing MAMI into current h&n facility structures. In human resources, there was a perceived barrier for the need for increased number of staff for MAMI, although getting staff with the accurate level might be a barrier it was expressed that with the right training and supervision this could be overcome. An organisational opportunity was that MAMI implementation was already prioritized, enabling the decision-making process. Some highlighted the tension between h&n projects as a barrier. Contextual barriers were the current COVID-19 pandemic and certain cultural practices. Current donors were supportive of the organization implementing MAMI.

Conclusion: Although there were some clear barriers, participants explored ways to overcome these barriers. Overall participants were positive of MAMI implementation and saw that there was support both from within the organisation and donors.

 

This research was carried out as a final project for the MSc Nutrition for Global Health at the London School of Hygiene and Tropical Medicine.

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Astrid Klomp (2021). Opportunities and barriers in scale-up of Management of small and nutritionally At-risk Infants under six months and their Mothers (MAMI) in four humanitarian settings: a qualitative study.. www.ennonline.net/opportunitiesandbarriersinscaleupofmami

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