Management challenges of supplementary feeding programs for severe acute malnutrition among children under five
Ketema Degefa1, Luisa Schneider1, Freek Colombijn1
1Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Insights
Nutritional programs in Eastern Ethiopia struggle to combat severe acute malnutrition due to healthcare worker workload, limited access, and inconsistent supplement availability. Addressing childhood malnutrition requires a long-term, community-inclusive approach starting before birth.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Severe acute malnutrition (SAM) in children under five is a critical health issue in Ethiopia, leading to significant morbidity and mortality.
- Existing nutritional programs face challenges in effective implementation, particularly in Eastern Ethiopia, necessitating an in-depth examination of contributing factors.
Purpose of the Study:
- To investigate the reasons behind the ineffectiveness of nutritional programs aimed at treating severe acute malnutrition in children under five in Eastern Ethiopia.
- To identify key challenges hindering the successful implementation of these vital public health interventions.
Main Methods:
- A qualitative research approach was utilized, involving in-depth interviews, focus group discussions, and participant observations.
- Data were collected from mothers, healthcare workers, and traditional birth attendants between April-June 2023 and February-March 2024.
- Thematic analysis was applied to transcribed and coded data to identify recurring themes and patterns.
Main Results:
- Five major themes emerged, highlighting challenges in SAM management, the influence of grandmothers, the 1000-day approach, behavioral interventions, and health worker-related factors.
- Programmatic hindrances include excessive healthcare worker workloads, restricted access to facilities, unreliable nutritional supplement supply, and insufficient support.
- Delayed health-seeking behaviors among caregivers present significant behavioral obstacles to effective malnutrition treatment.
Conclusions:
- The study concludes that limited healthcare access, inconsistent supplement availability, inadequate support, and delayed health-seeking behaviors impede the success of nutritional feeding programs.
- Effective malnutrition interventions must adopt a comprehensive, long-term strategy, recognizing that care begins prenatally.
- Intergenerational caregiving dynamics and robust community-healthcare worker collaboration are crucial for improving outcomes.
Purpose:
The study examines the challenges of implementing nutritional programs to address severe acute malnutrition in children under five, a major cause of illness and death in Ethiopia. This paper examines why nutritional programs are ineffective in Eastern Ethiopia.
Methods:
The research, conducted from April to June 2023 and from February to March 2024, included in-depth interviews, focus groups, and participant observations with mothers, healthcare workers, and traditional birth attendants. Thematic analysis was employed to identify key themes within the transcribed and coded data.
Results:
Five themes representing challenges in implementing nutritional feeding programs to address severe acute malnutrition among children under five were identified in the interviews, focus group discussions and observations. These themes are: management steps for severe acute malnutrition; the role of grandmothers in severe acute malnutrition treatment; the 1000-day approach to tackle malnutrition at early stages; behavioural and knowledge-building focused intervention; and factors influencing the management of SAM among health workers. The feeding program is hindered by too high workloads of the healthcare workers, limited access to healthcare facilities, inconsistent availability of nutritional supplements, and inadequate support for malnutrition. Delayed health-seeking behaviours pose behavioural challenges.
Conclusions:
The feeding program encounters challenges due to limited access to healthcare, inconsistent availability of nutritional supplements, inadequate support for malnutrition, and delayed health-seeking behaviour. Addressing malnutrition begins before a child's birth and requires a comprehensive and long-term strategy. Intergenerational caregiving and effective collaboration between communities and healthcare workers can offer valuable insights.
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