Exploring current barriers and enablers of severe acute malnutrition management among children (6-59 months): perspectives from health professionals in northern Ghana.

Abstract

Introduction: Malnutrition is a common global health problem that affects children under five years of age. This study aimed to explore current barriers and facilitators from the perspective of health personnel at Tamale Teaching Hospital and Kings Medical Centre in the clinical management of severe acute malnutrition (SAM) among children (6-59 months).

Methods: This study used a qualitative research approach and employed a semi-structured interview guide, interviews (key informants), in-depth interviews, and focus group discussions. A total of 30 staff from both facilities, who were directly involved in SAM management, were purposively sampled. The research explored areas of SAM management, including workload, training, referrals, staff collaboration, therapeutic formula availability and vital infrastructure. Findings The findings revealed a lack of standardised training, emphasising the critical role of capacity development for effective case management. The absence of ready-to-use therapeutic food in both facilities, worsened by global economic crises, has led to reliance on locally formulated alternatives. Late referrals, high workloads and limited staff collaboration were highlighted as notable obstacles, impacting the overall quality of care. The enablers of SAM management included integration between nutrition and healthcare services, the availability of locally prepared therapeutic formulae, albeit limited, supportive infrastructure, and successful collaboration with hospital administration.

Conclusion: This study revealed critical obstacles and facilitators in the management of SAM among children (6-59 months). Recommendations are geared towards providing training protocols for health professionals, enhancing supply chain mechanisms to ensure the availability of therapeutic foods, and fostering a culture of collaboration within healthcare teams. Thus, when these challenges are addressed while at the same time leveraging existing enablers, health systems can significantly improve treatment outcomes of SAM cases. The findings will inform policy decisions by governmental bodies, health systems, and non-governmental organisations, guiding resource allocation, effective interventions, and overall improvement in care for malnourished children.