Alim Md Abdul, Marium Bibi, Guesdon Benjamin, Munirul Islam M, Antoine Caroline, Anik Mehedi Hasan, De Henauw Stefaan, Ahmed Tahmeed, Abbeddou Souheila
Institute of Public Health Nutrition, Directorate General of Health Services, Dhaka, Bangladesh.
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Matern Child Nutr. 2025 Jul;21(3):e70030. doi: 10.1111/mcn.70030. Epub 2025 Apr 8.
Acute Malnutrition affects 45 million children under five globally, with Bangladesh contributing more than 1.7 million cases. While community-based management of acute malnutrition (CMAM) guidelines in Bangladesh exist, they primarily emphasise nutritional counselling and face challenges in coverage and implementations. It is important to understand barriers to CMAM uptake and implementation. This study aims to explore the perceptions of acute malnutrition's underlying factors and consequences among parents, healthcare providers, and policymakers, alongside parents' care-seeking behaviours for under-five children with acute malnutrition. Conducted in areas with and without CMAM programs, the research follows a phenomenological design with thematic analysis of focus group discussions (FGDs) and key informant interviews (KIIs). Thirty FGDs with parents, 28 KIIs with healthcare providers, and 16 KIIs with policymakers were conducted. Identified causes of acute malnutrition included infections, diseases, lack of awareness about nutritious foods, supernatural beliefs, poverty, and inadequate care and feeding practices. Consequences included stunted growth, impaired mental development, and increased illness risk. Although parents acknowledged the urgency of treating acute malnutrition, they sought care at healthcare facilities regardless of illness. Factors influencing care-seeking behaviour were inability in problem prioritisation, transportation cost and availability, healthcare access, wage loss, and out-of-pocket expenses. Despite awareness of acute malnutrition's underlying factors and consequences, parental care-seeking remains limited. The study recommends integrating acute malnutrition guidelines with communicable disease programs, implementing targeted social and behavioural change programs, addressing superstitions, fostering collaboration with traditional healers strengthening social safety nets, and empowering women in healthcare decision-making.
全球有4500万五岁以下儿童受到急性营养不良的影响，其中孟加拉国的病例超过170万例。虽然孟加拉国存在基于社区的急性营养不良管理（CMAM）指南，但这些指南主要强调营养咨询，在覆盖范围和实施方面面临挑战。了解CMAM采用和实施的障碍很重要。本研究旨在探讨父母、医疗保健提供者和政策制定者对急性营养不良的潜在因素和后果的看法，以及父母对五岁以下急性营养不良儿童的就医行为。该研究在有和没有CMAM项目的地区进行，采用现象学设计，对焦点小组讨论（FGD）和关键信息提供者访谈（KII）进行主题分析。与父母进行了30次FGD，与医疗保健提供者进行了28次KII，与政策制定者进行了
