Engler Ramona, McGrath Marie, Kerac Marko
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Emergency Nutrition Network, Oxford, OX5 2DN, UK.
Children (Basel). 2023 Sep 1;10(9):1496. doi: 10.3390/children10091496.
Skilled staff are essential for successfully managing child malnutrition, especially when dealing with small, nutritionally at-risk infants aged under 6 months. Training and patient management tools provide healthcare workers with core knowledge, skills, and support. To inform more effective future approaches and support the rollout of new WHO wasting prevention/treatment guidelines, we aimed to map and understand globally available training and patient management tools. In a mixed-methods study, we searched the literature to identify different training packages and management tools and conducted semi-structured key informant interviews with staff working in a variety of internationally organizations and settings. Data were analyzed using a phenomenological approach. We found 14 different training packages targeting different settings, including inpatient, outpatient, and humanitarian contexts. Curricula varied, especially around breastfeeding and maternal assessment, mental health, and nutritional status. Key informants (n = 9) reported gaps regarding counseling skills, time for practice, and how to effectively provide mental health counseling. Training delivery was highly dependent on resources and setting. In conclusion, future training should consider setting-specific needs, opportunities, and limitations. Emphasis on breastfeeding-support skills, mental health support, and counseling skills is needed. Enhanced practical sessions, refresher trainings, and ongoing monitoring and support are vital to ensure sustained high-quality services.
熟练的工作人员对于成功管理儿童营养不良至关重要,尤其是在处理6个月以下、营养状况不佳的小婴儿时。培训和患者管理工具为医护人员提供了核心知识、技能和支持。为了为未来更有效的方法提供信息,并支持世界卫生组织新的消瘦预防/治疗指南的推广,我们旨在梳理和了解全球可用的培训和患者管理工具。在一项混合方法研究中,我们检索了文献以识别不同的培训包和管理工具,并对在各种国际组织和环境中工作的人员进行了半结构化关键信息访谈。使用现象学方法对数据进行了分析。我们发现了14种针对不同环境的不同培训包,包括住院、门诊和人道主义环境。课程各不相同,尤其是在母乳喂养和产妇评估、心理健康以及营养状况方面。关键信息提供者(n = 9)报告了在咨询技能、实践时间以及如何有效提供心理健康咨询方面存在差距。培训的提供高度依赖于资源和环境。总之,未来的培训应考虑特定环境的需求、机会和限制。需要强调母乳喂养支持技能、心理健康支持和咨询技能。加强实践课程、进修培训以及持续的监测和支持对于确保持续提供高质量服务至关重要。