Adapting acute malnutrition treatment protocols in emergency contexts: a qualitative study of national decision-making

Conflict and Health
Naoko KozukiSarah L Dalglish

Abstract

Each year, an estimated 17 million children suffer from severe acute malnutrition (SAM) and 33 million from moderate acute malnutrition (MAM), with many of the most severe cases found in extremely food insecure contexts or conflict situations. Current global outpatient treatment protocols for uncomplicated SAM and MAM, adapted by most countries for use at national level, call for SAM and MAM to be managed separately, however global-level stakeholders have recently begun evaluating simplified and/or combined protocols managing acute malnutrition. This study analyzes national policy discussions and decision-making around outpatient acute malnutrition treatment for uncomplicated cases in emergency situations in Niger, Nigeria, Somalia, and South Sudan. Data collection (March-July 2018) included semi-structured in-depth interviews with 50 respondents (N = 11-15 per country) from government, funding agencies, and implementing partners, as well as 11 global and regional stakeholders. We also conducted a document analysis (N = 10-15 per country and at global level) to situate debates and evaluate current policy. Data were analyzed iteratively using thematic content analysis. We find that while combined/simplified protocols for outpati...Continue Reading

References

Jan 22, 2008·Lancet·Robert E BlackUNKNOWN Maternal and Child Undernutrition Study Group
Dec 4, 2009·The International Journal of Health Planning and Management·Tim O'Dempsey, Barry Munslow
Jun 12, 2013·Lancet·Robert E BlackUNKNOWN Maternal and Child Nutrition Study Group
Dec 30, 2014·Social Science & Medicine·Sebastian A J TaylorEric Brunner
Feb 14, 2016·Health Policy and Planning·Adam D KoonSusannah H Mayhew
Apr 22, 2019·Health Policy and Planning·Jody Harris

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Clinical Trials Mentioned

ISRCTN30393230
NCT03751475

Software Mentioned

NVivo
OptiMA
MUAC
ComPAS
MAM Decision Tool

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