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基于社区的急性营养不良管理:实施质量以及工作人员和服务使用者的满意度。

Community-based management of acute malnutrition: Implementation quality, and staff and user satisfaction with services.

作者信息

Akuu Joshua A, Amagnya Moses A

机构信息

School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.

Institute of Policing, School of Justice, Security and Sustainability, Staffordshire University, Stoke-on-Trent, United Kingdom.

出版信息

J Taibah Univ Med Sci. 2023 Feb 17;18(5):988-996. doi: 10.1016/j.jtumed.2023.02.002. eCollection 2023 Oct.

Abstract

BACKGROUND

Malnutrition is a problem that affects many children and therefore is the focus of multiple interventions worldwide. One intervention is community-based management of acute malnutrition (CMAM).

OBJECTIVE

This study assessed CMAM implementation quality in the Builsa North District of Ghana, and the satisfaction among both users and CMAM staff.

DESIGN

The study used a convergent mixed-method design involving in-depth interviews with CMAM staff and users, document reviews, and observations of the CMAM implementation. The data were collected across eight health care facilities in eight sub-districts. The data were qualitatively and thematically analysed in Nvivo software.

RESULTS

Several factors were found to adversely affect the quality of CMAM implementation. Significant factors included inadequate training of CMAM workers; religious belief systems; and a lack of implementation materials, such as ready-to-use therapeutic food (RUTF), CMAM registration forms/cards, and computers. These factors adversely affected programme quality, thus resulting in dissatisfaction among CMAM users and staff.

CONCLUSION

This study established that the CMAM programme in the Builsa North District of Ghana is hindered by a lack of primary resources and logistics necessary for successful programme implementation. Most health facilities in the district lack such resources and are not delivering the intended results.

摘要

背景

营养不良是一个影响众多儿童的问题,因此是全球多项干预措施的重点。其中一项干预措施是基于社区的急性营养不良管理(CMAM)。

目的

本研究评估了加纳布尔萨北区CMAM的实施质量以及使用者和CMAM工作人员的满意度。

设计

本研究采用了收敛性混合方法设计,包括对CMAM工作人员和使用者进行深入访谈、文件审查以及对CMAM实施情况的观察。数据收集于八个分区的八个医疗保健机构。数据在Nvivo软件中进行了定性和主题分析。

结果

发现有几个因素对CMAM的实施质量产生了不利影响。重要因素包括CMAM工作人员培训不足;宗教信仰体系;以及缺乏实施材料,如即食治疗性食品(RUTF)、CMAM登记表/卡和电脑。这些因素对项目质量产生了不利影响,从而导致CMAM使用者和工作人员不满。

结论

本研究表明,加纳布尔萨北区的CMAM项目因缺乏成功实施项目所需的主要资源和后勤保障而受到阻碍。该地区的大多数卫生设施缺乏此类资源,未能取得预期效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e8c/9986645/33c469337de1/gr1.jpg

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