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Published on: February 5, 2019
A comparison of the programme coverage of two therapeutic feeding interventions implemented in neighbouring districts
Kate Sadler1, Mark Myatt, Teshome Feleke
1Centre for International Child Health, Institute of Child Health, London, WC1N 1EH, UK. kate@validinternational.org
Insights
Community-based therapeutic care (CTC) significantly improved severe malnutrition treatment coverage compared to therapeutic feeding centres (TFCs) in Malawi. CTC programs demonstrated higher reach, leading to a greater impact on child malnutrition.
Area of Science:
- Global Health
- Pediatric Nutrition
- Malnutrition Interventions
Background:
- Severe acute malnutrition poses a significant threat to child survival globally.
- Traditional therapeutic feeding centres (TFCs) have limitations in reaching all eligible children.
- Community-based therapeutic care (CTC) models aim to decentralize treatment for improved access.
Purpose of the Study:
- To compare the therapeutic feeding programme coverage achieved by CTC and TFC programs in Malawi.
- To evaluate the effectiveness of different malnutrition treatment delivery models.
Main Methods:
- Simultaneous surveys conducted in two neighboring districts with CTC and TFC programs.
- Stratified sampling design using centric systematic area sampling.
- Case-finding approach to identify children under 5 with severe malnutrition (
- Period and point coverage estimates calculated.
Main Results:
- CTC achieved a period coverage of 73.64% (CI: 66.0-81.3%) versus 24.55% (CI: 17.8-31.4%) for TFC.
- CTC achieved a point coverage of 59.95% (CI: 51.4-68.5%) versus 20.04% (CI: 13.8-26.3%) for TFC.
- Substantially higher coverage rates for CTC programs were observed.
Conclusions:
- Community-based therapeutic care (CTC) programs provide substantially higher coverage for severe malnutrition treatment than TFC programs.
- The enhanced reach of CTC programs translates to a greater impact on reducing severe malnutrition in the studied population.
- Decentralized, community-based approaches are more effective in delivering malnutrition interventions.
Objective:
To compare therapeutic feeding programme coverage for severely malnourished children achieved by a community-based therapeutic care (CTC) programme and a therapeutic feeding centre (TFC) programme operating in neighbouring districts in Malawi.
Design:
Two surveys were implemented simultaneously one in each of the two programme areas. Each survey used a stratified design with strata defined using the centric systematic area sample method. Thirty 100 km2 quadrats were sampled. The community or communities located closest to the centre of each quadrat were sampled using a case-finding approach. Cases were defined as children aged under 5 years with
Results:
Overall the period coverage was 24.55% (95% confidence interval (CI) = 17.8-31.4%) in the TFC programme and 73.64% (95% CI = 66.0-81.3%) in the CTC programme. The point coverage was 20.04% (95% CI = 13.8-26.3%) in the TFC programme and 59.95% (95% CI = 51.4-68.5%) in the CTC programme.
Conclusions:
In this context, CTC gave substantially higher programme coverage than a TFC programme. Given effective treatment, this enabled higher impact of CTC on severe malnutrition in this population.