Inpatient and outpatient treatment for acute malnutrition in infants under 6 months; a qualitative study from Senegal

Autor: Tabitha D. van Immerzeel, Indou Deme Ly, Maty Diagne Camara, Rosemarijn J. de Jong
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Breastfeeding
Acute malnutrition <6 months
Health Services Accessibility
Health administration
0302 clinical medicine
Outpatients
Ambulatory Care
Medicine
030212 general & internal medicine
Health Education
Qualitative Research
Community engagement
030503 health policy & services
Health Policy
lcsh:Public aspects of medicine
Outpatient
Infant Malnutrition
Focus Groups
Infant Formula
Infant Nutrition Disorders
Senegal
Hospitalization
Breast Feeding
Acute Disease
Female
Health education
Inpatient
0305 other medical science
Research Article
Infant malnutrition
medicine.medical_specialty
Referral
Health Personnel
Mothers
Nutritional Status
03 medical and health sciences
Ambulatory care
Humans
Quality of Health Care
Inpatients
business.industry
Infant
Newborn
Infant
lcsh:RA1-1270
medicine.disease
Treatment
Malnutrition
Family medicine
business
Facilities and Services Utilization
Young infant feeding
Zdroj: BMC Health Services Research, Vol 19, Iss 1, Pp 1-10 (2019)
BMC Health Services Research
ISSN: 1472-6963
DOI: 10.1186/s12913-019-3903-x
Popis: Background Treatment of acute malnutrition in infants under 6 months is a relevant topic regarding the global problem of maternal and child malnutrition. While treatment for older age groups has shifted more towards an outpatient, community based approach, young infants are mostly treated in hospital. This study aims to describe barriers and facilitators for outpatient and inpatient treatment of malnourished infants under 6 months in Senegal. Methods This qualitative descriptive study uses in-depth interviews with health workers and focus group discussions with mothers of malnourished infants, conducted from June to September 2015 in two case clinics. In data analysis, Collins’ 3 key factors for a successful nutrition program were used as a theoretical framework: access, quality of care and community engagement. Results Within Collins’ 3 key factors, 9 facilitators and barriers have emerged from the data. Key factor access: Outpatient care was perceived as more accessible than inpatient concerning distance and cost, given that there is a milk supplement available. Trust could be more easily generated in an outpatient setting. Key factor quality of care: The cup and spoon re-lactation technique was efficiently used in outpatient setting, but needed close supervision. Basic medical care could be offered to outpatients provided that referral of complicated cases was adequate. Health education was more intensive with inpatients, but could be done with outpatients. Key factor community engagement: The community appeared to play a key role in treating malnourished young infants because of its influence on health seeking behaviour, peer support and breastfeeding practices. Conclusions Outpatient care does facilitate access, provided that an affordable milk supplement is available. Quality of care can be guaranteed using an appropriate re-lactation technique and a referral system for complications. The community has the potential to be much engaged, though more attention is required for breastfeeding education. In view of the magnitude of the health problem of young infant malnutrition and its strong relationship with breastfeeding practices, an outpatient community-based treatment approach needs to be considered.
Databáze: OpenAIRE
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