Effect of caregiver training on knowledge and confidence of at-home clinical and anthropometric surveillance of children with uncomplicated severe acute malnutrition: analysis of a cross-over cluster randomised trial in Sokoto, Nigeria
Nazia Binte Ali1,2, Matt Dt Hitchings3, Fatou Berthé4
1Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.
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View abstract on PubMed
Caregiver training significantly improved knowledge and confidence in monitoring severe acute malnutrition (SAM) at home. This supports task-shifting models for community-based SAM management in resource-limited settings.
Area of Science:
- Global Health
- Pediatrics
- Public Health
Background:
- Community-based management of severe acute malnutrition (SAM) is crucial in low-resource settings.
- Task-shifting models can alleviate health system pressure and improve treatment access.
- Caregiver engagement in clinical and anthropometric surveillance for SAM has not been extensively evaluated.
Purpose of the Study:
- To assess the impact of caregiver training on their knowledge and confidence in performing at-home clinical and anthropometric surveillance for children with uncomplicated SAM.
- To evaluate the effectiveness of a caregiver training program within a task-shifting framework for SAM management.
Main Methods:
- A cluster-randomised trial compared monthly follow-up with caregiver training to standard weekly follow-up for outpatient SAM management.
- Caregivers received training on clinical surveillance and mid-upper arm circumference (MUAC) measurement.
- Intention-to-treat analyses examined knowledge and confidence scores at various time points; MUAC measurement accuracy was compared between caregivers and study staff.
Main Results:
- Caregivers' knowledge and confidence in clinical surveillance significantly increased post-training and remained elevated.
- High agreement (>92%) was observed in MUAC classification between caregivers and study staff.
- Caregivers in the training group showed significantly greater knowledge and confidence scores compared to the standard care group.
Conclusions:
- Caregiver training effectively enhances knowledge and confidence in at-home surveillance for uncomplicated SAM.
- Task-shifting models involving trained caregivers are a viable strategy for community-based SAM management.
- Findings support the wider implementation of caregiver training in similar resource-limited settings for SAM treatment.
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