Primary healthcare readiness for nutritionally at-risk infants aged under 6 months: a facility-based survey in Senegal.

IF 2.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Tabitha D van Immerzeel, Indou Deme-Ly, Maty Diagne-Camara, Rebecca E Penzias, Daouda Seck, Abdallah Diallo, Amanda E Murungi, Carlos S Grijalva-Eternod, Marko Kerac, Abou Ba, Louise T Day
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引用次数: 0

Abstract

Background: Malnutrition in infants aged <6 mo (u6m) is poorly identified and managed in many countries, increasing the risk of poor growth and development. Addressing this gap, 2023 WHO malnutrition guidelines recommend assessment, classification and treatment at primary care level. This study aimed to assess primary healthcare facility readiness for nutritional care in infants u6m.

Methods: We adapted the Harmonized Health Facility Assessment (HHFA), adding items for Management of small and nutritionally At-risk Infants u6m and their Mothers (MAMI) at five care contact points. Our HHFA-MAMI tool captured 342 items using healthcare provider interviews, observations and registers data to calculate mean scores per area and median patient visits.

Results: We surveyed 15 facilities in Senegal. General readiness scored 69.5%, MAMI availability and readiness 37.7%. Infrastructure (72.0%) and health workforce (60.7%) were available, while equipment (32.5%) and training (22.3%) scored low. Infants were frequently assessed (53.6%), not often classified (15.2%) as at risk, nor adequately treated (38.2%). Comparing contact points, delivery and sick child clinic scored highest in readiness, immunization in utilization.

Conclusions: Primary care readiness gaps exist in classifying and treating at-risk infants u6m, equipment and training. We found opportunities at each of the five contact points to implement WHO-recommended care.

背景大龄婴儿营养不良 方法:我们对统一医疗机构评估(HHFA)进行了改编,在五个医疗接触点增加了6岁以下小婴儿和营养高危婴儿及其母亲管理(MAMI)的项目。我们的 HHFA-MAMI 工具使用医疗服务提供者访谈、观察和登记数据采集了 342 个项目,以计算每个地区的平均得分和患者就诊次数的中位数:我们对塞内加尔的 15 家医疗机构进行了调查。总体准备度为 69.5%,MAMI 可用性和准备度为 37.7%。基础设施(72.0%)和医务人员队伍(60.7%)可用,而设备(32.5%)和培训(22.3%)得分较低。经常对婴儿进行评估(53.6%),但并不经常将其归类为高危婴儿(15.2%),也没有对其进行充分治疗(38.2%)。比较接触点,分娩和病童诊所的准备程度最高,免疫接种的利用率最高:结论:在对 6 岁以下高危婴儿进行分类和治疗、设备和培训方面,初级保健的准备程度存在差距。我们发现五个联络点都有机会实施世界卫生组织推荐的护理。
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来源期刊
International Health
International Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.50
自引率
0.00%
发文量
83
审稿时长
>12 weeks
期刊介绍: International Health is an official journal of the Royal Society of Tropical Medicine and Hygiene. It publishes original, peer-reviewed articles and reviews on all aspects of global health including the social and economic aspects of communicable and non-communicable diseases, health systems research, policy and implementation, and the evaluation of disease control programmes and healthcare delivery solutions. It aims to stimulate scientific and policy debate and provide a forum for analysis and opinion sharing for individuals and organisations engaged in all areas of global health.
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