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Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
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Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
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Journal Article
Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic
2025
Overview
Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to treat both MAM and SAM has drawn research and policy interest among global, regional and national stakeholders. However, the perspectives of local communities and health care workers regarding the use of protocols to treat acute malnutrition in a routine health care system are generally lacking. This was a cross‐sectional mixed‐methods study aimed at assessing the perceptions of different stakeholders on the use of a simplified, combined protocol in two districts in the Central African Republic. Most of the respondents preferred the simplified, combined protocol over the standard protocol. They generally agreed that the protocol was easy to understand, allowed more children to receive treatment and was effective in treating acute malnutrition. The protocol modifications were well received, including the expanded admission criteria, use of mid‐upper arm circumference (MUAC) only for admission and discharge criteria and reduced and simplified ready‐to‐use therapeutic food quantity to treat MAM and SAM. Some caregivers expressed concern with the use of MUAC only to declare recovery, flagging that underlying illnesses could still be present. The caregivers recommended the provision of other food basket interventions to improve the treatment. The support by caregivers and health care workers on the idea of training community health volunteers to treat acute malnutrition points to the potential of scaling up decentralized treatment to increase coverage in remote areas. The use of the simplified, combined protocol to treat acute malnutrition was well received and supported by most stakeholders involved in implementation. The protocol provided care for children with moderate or severe acute malnutrition (MAM or SAM) within a shorter treatment duration and using a reduced ready‐to‐use therapeutic food dose. Key messages The use of the simplified, combined protocol to treat acute malnutrition received overwhelming support from most stakeholders involved in implementation. Stakeholders were supportive of the use of the protocol to provide care for both severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) children with a shorter length of stay in treatment. Most stakeholders supported the use of mid‐upper arm circumference only for the admission and discharge of children. The majority of stakeholders reported that the ready‐to‐use therapeutic food given for MAM and SAM was sufficient for the child's recovery. The idea of training and equipping community health volunteers to treat acute malnutrition was well supported by caregivers and health care workers and should be explored further.
Publisher
John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
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