Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic

Abstract Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to tr...

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Main Authors: Francis M. Ngure, Zachary Tausanovitch, Grace A. Heymsfield, Siolo Mada Bebelou, Parfait Seboulo, Benedict Tabiojongmbeng, Anne Marie Dembele, Issa Niamanto Coulibaly, Victor Nikièma, Jeanette Bailey, Suvi T. Kangas
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Maternal and Child Nutrition
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Online Access:https://doi.org/10.1111/mcn.13743
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author Francis M. Ngure
Zachary Tausanovitch
Grace A. Heymsfield
Siolo Mada Bebelou
Parfait Seboulo
Benedict Tabiojongmbeng
Anne Marie Dembele
Issa Niamanto Coulibaly
Victor Nikièma
Jeanette Bailey
Suvi T. Kangas
author_facet Francis M. Ngure
Zachary Tausanovitch
Grace A. Heymsfield
Siolo Mada Bebelou
Parfait Seboulo
Benedict Tabiojongmbeng
Anne Marie Dembele
Issa Niamanto Coulibaly
Victor Nikièma
Jeanette Bailey
Suvi T. Kangas
author_sort Francis M. Ngure
collection DOAJ
description Abstract Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to treat both MAM and SAM has drawn research and policy interest among global, regional and national stakeholders. However, the perspectives of local communities and health care workers regarding the use of protocols to treat acute malnutrition in a routine health care system are generally lacking. This was a cross‐sectional mixed‐methods study aimed at assessing the perceptions of different stakeholders on the use of a simplified, combined protocol in two districts in the Central African Republic. Most of the respondents preferred the simplified, combined protocol over the standard protocol. They generally agreed that the protocol was easy to understand, allowed more children to receive treatment and was effective in treating acute malnutrition. The protocol modifications were well received, including the expanded admission criteria, use of mid‐upper arm circumference (MUAC) only for admission and discharge criteria and reduced and simplified ready‐to‐use therapeutic food quantity to treat MAM and SAM. Some caregivers expressed concern with the use of MUAC only to declare recovery, flagging that underlying illnesses could still be present. The caregivers recommended the provision of other food basket interventions to improve the treatment. The support by caregivers and health care workers on the idea of training community health volunteers to treat acute malnutrition points to the potential of scaling up decentralized treatment to increase coverage in remote areas.
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spelling doaj-art-34a6852e168943eca7a698cb727b3f112025-08-20T01:58:11ZengWileyMaternal and Child Nutrition1740-86951740-87092025-01-01211n/an/a10.1111/mcn.13743Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African RepublicFrancis M. Ngure0Zachary Tausanovitch1Grace A. Heymsfield2Siolo Mada Bebelou3Parfait Seboulo4Benedict Tabiojongmbeng5Anne Marie Dembele6Issa Niamanto Coulibaly7Victor Nikièma8Jeanette Bailey9Suvi T. Kangas10Nutrition Research Consultant Nairobi KenyaInternational Rescue Committee New York New York USAInternational Rescue Committee New York New York USAMinistry of Health and Population Bangui Central African RepublicMinistry of Health and Population Bangui Central African RepublicWorld Food Program Bangui Central African RepublicUnited Nations Children's Fund Bangui Central African RepublicInternational Rescue Committee Bamako MaliWorld Food Program Regional Bureau for West Africa Dakar SenegalInternational Rescue Committee New York New York USAInternational Rescue Committee New York New York USAAbstract Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to treat both MAM and SAM has drawn research and policy interest among global, regional and national stakeholders. However, the perspectives of local communities and health care workers regarding the use of protocols to treat acute malnutrition in a routine health care system are generally lacking. This was a cross‐sectional mixed‐methods study aimed at assessing the perceptions of different stakeholders on the use of a simplified, combined protocol in two districts in the Central African Republic. Most of the respondents preferred the simplified, combined protocol over the standard protocol. They generally agreed that the protocol was easy to understand, allowed more children to receive treatment and was effective in treating acute malnutrition. The protocol modifications were well received, including the expanded admission criteria, use of mid‐upper arm circumference (MUAC) only for admission and discharge criteria and reduced and simplified ready‐to‐use therapeutic food quantity to treat MAM and SAM. Some caregivers expressed concern with the use of MUAC only to declare recovery, flagging that underlying illnesses could still be present. The caregivers recommended the provision of other food basket interventions to improve the treatment. The support by caregivers and health care workers on the idea of training community health volunteers to treat acute malnutrition points to the potential of scaling up decentralized treatment to increase coverage in remote areas.https://doi.org/10.1111/mcn.13743Central African Republiccombined protocolmid‐upper arm circumference (MUAC)ready‐to‐use therapeutic food (RUTF)simplifiedstakeholders
spellingShingle Francis M. Ngure
Zachary Tausanovitch
Grace A. Heymsfield
Siolo Mada Bebelou
Parfait Seboulo
Benedict Tabiojongmbeng
Anne Marie Dembele
Issa Niamanto Coulibaly
Victor Nikièma
Jeanette Bailey
Suvi T. Kangas
Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
Maternal and Child Nutrition
Central African Republic
combined protocol
mid‐upper arm circumference (MUAC)
ready‐to‐use therapeutic food (RUTF)
simplified
stakeholders
title Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
title_full Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
title_fullStr Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
title_full_unstemmed Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
title_short Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
title_sort perceptions of stakeholders on the use of a simplified combined protocol for treatment of acute malnutrition in central african republic
topic Central African Republic
combined protocol
mid‐upper arm circumference (MUAC)
ready‐to‐use therapeutic food (RUTF)
simplified
stakeholders
url https://doi.org/10.1111/mcn.13743
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