Impact of different levels of supervision on the recovery of severely malnourished children treated by community health workers in Mali

Research output: Contribution to journalJournal articlepeer-review

Documents

  • Pilar Charle-Cuéllar
  • Noemí López-Ejeda
  • Mamadou Traore
  • Adama Balla Coulibaly
  • Aly Landouré
  • Fatou Diawara
  • Magloire Bunkembo
  • Antonio Vargas
  • Ruth Gil
  • André Briend

Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). 

Methods: This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. 

Results: A total of 6112 children aged 6-59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. 

Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.

Original languageEnglish
Article number367
JournalNutrients
Volume13
Issue number2
Number of pages14
ISSN2072-6643
DOIs
Publication statusPublished - 2021

    Research areas

  • Faculty of Science - Severe Acute Malnutrition (SAM), Community Health Workers (CHW), Integrated Community Case Management (iCCM), Supportive supervision, Scaling-up interventions

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