Programmatic adaptations to acute malnutrition screening and treatment during the COVID-19 pandemic.
COVID-19
Family MUAC
assessment of nutritional status
community-based
community-based management of acute malnutrition (CMAM)
infant and child nutrition
low-income countries
malnutrition
programme components
simplified approaches
wasting
Journal
Maternal & child nutrition
ISSN: 1740-8709
Titre abrégé: Matern Child Nutr
Pays: England
ID NLM: 101201025
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
13
06
2022
received:
17
02
2022
accepted:
21
06
2022
pubmed:
6
8
2022
medline:
21
9
2022
entrez:
5
8
2022
Statut:
ppublish
Résumé
The COVID-19 pandemic presented numerous challenges to acute malnutrition screening and treatment. To enable continued case identification and service delivery while minimising transmission risks, many organisations and governments implemented adaptations to community-based management of acute malnutrition (CMAM) programmes for children under 5. These included: Family mid-upper arm circumference (MUAC); modified admission and discharge criteria; modified dosage of therapeutic foods; and reduced frequency of follow-up visits. This paper presents qualitative findings from a larger mixed methods study to document practitioners' operational experiences and lessons learned from these adaptations. Findings reflect insights from 37 interviews representing 15 organisations in 17 countries, conducted between July 2020 and January 2021. Overall, interviewees indicated that adaptations were mostly well-accepted by staff, caregivers and communities. Family MUAC filled screening gaps linked to COVID-19 disruptions; however, challenges included long-term accuracy of caregiver measurements; implementing an intervention that could increase demand for inconsistent services; and limited guidance to monitor programme quality and impact. Modified admission and discharge criteria and modified dosage streamlined logistics and implementation with positive impacts on staff workload and caregiver understanding of the programme. Reduced frequency of visits enabled social distancing by minimising crowding at facilities and lessened caregivers' need to travel. Concerns remained about how adaptations impacted children's identification for and progress through treatment and programme outcomes. Most respondents anticipated reverting to standard protocols once transmission risks were mitigated. Further evidence, including multi-year programmatic data analysis and rigorous research, is needed in diverse contexts to understand adaptations' impacts, including how to ensure equity and mitigate unintended consequences.
Identifiants
pubmed: 35929509
doi: 10.1111/mcn.13406
pmc: PMC9480950
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13406Informations de copyright
© 2022 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
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