Malnutrition
Overview
Source: WHO
What HIFA2015 members say
Quotes from the literature
‘Severe malnutrition was both under-diagnosed and wrongly diagnosed by nurses trained in the use of the IMCI nutrition algorithm in a clinic setting in The Gambia. These guidelines for health workers and the training materials, particularly with respect to calculation of age, need further development to improve the detection of malnourished children.’
Hamer C et al 2004
Clinical guidelines and external training [in rural South African hospitals] are valuable but may be insufficient to ensure quality of care… unless there are supportive structures at managerial level, the potential benefits of efficacious interventions and related training programmes to improve health worker performance can be thwarted.
Puoane T et al 2008
‘Guidelines for severe malnutrition [in rural South African hospitals] are largely feasible but training workshops are insufficient to achieve optimal management as staff turnover and an unsupportive health system erode the gains made and doctors treat cases without having being trained.’
Karaolis N et al 2007
‘Underlying reasons for the negative attitudes [of nurses in 11 hospitals in South Africa] towards severely malnourished children and their caregivers were misunderstandings of the causes of malnutrition, misinterpretation of clinical signs, especially poor appetite, and high mortality during treatment… Experience in this province has shown that in-service training changes attitudes to malnutrition and treatment practices, as well as saving lives.’
Puoane T et al 2006
‘The nurses’ poor detection and targeting of nutritionally at-risk children were largely a result of failure to plot weights on the weight-for-age chart (55%) and poor utilisation of the Road to Health Chart.’
Schoeman SE et al 2006
‘Uncomplicated forms of severe acute malnutrition should be treated in the community… If properly combined with a facility-based approach for those malnourished children with medical complications and implemented on a large scale, community-based management of severe acute malnutrition could prevent the deaths of hundreds of thousands of children… Countries can save children’s lives by… training and support for community health workers to identify children with severe acute malnutrition who need urgent treatment and to recognize those children with associated complications who need urgent referral.’
WHO, WFP, UNSSCN, UNICEF 2007
References
Hamer C et al. Detection of severe protein-energy malnutrition by nurses in The Gambia. Arch Dis Child 2004;89:181–184 (all ADC articles before 1 January 2006 are free access)
Karaolis N et al. WHO guidelines for severe malnutrition: are they feasible in rural African hospitals? Arch Dis Child 2007;92:198-204 (restricted access)
Puoane T et al Training nurses to save lives of malnourished children. Curationis 2006;29:73-78 (restricted access)
Puoane T et al Why do some hospitals achieve better care of severely malnourished children than others? Five-year follow-up of rural hospitals in Eastern Cape, South Africa. Health Policy and Planning 2008;23:428-437 (restricted access)
Schoeman SE et al. The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa. Public Health Nutr 2006 Dec;9(8):1007-12 (restricted access)
