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African Journal of Food, Agriculture, Nutrition and Development
Rural Outreach Program
ISSN: 1684-5358 EISSN: 1684-5358
Vol. 17, No. 4, 2017, pp. 12678-12690
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Bioline Code: nd17088
Full paper language: English
Document type: Research Article
Document available free of charge
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African Journal of Food, Agriculture, Nutrition and Development, Vol. 17, No. 4, 2017, pp. 12678-12690
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MANAGING ACUTE MALNUTRITION IN INFANTS AGED LESS THAN SIX MONTHS: A QUALITATIVE ASSESSMENT IN NIGER PUBLIC HOSPITALS
Hallarou, M ELH.; Doudou, HM; Manzo, ML; Donnen, P; Dramaix, M & Ousmane, N
Abstract
Quality management of severe acute malnutrition (SAM) in infants < 6 months of age
is a key strategy within the “1000 days window of opportunity”. It prevents early child
death, secures optimal growth and forms a foundation for full adulthood potentials.
Most studies to date on management of SAM in infants relied on informants from Non-Governmental Organizations staff or government public health officials but little is
known from hospital practitioners. From June to August 2013, a qualitative appraisal of
hospital practitioners’ views on the current quality of care for malnourished infants was
conducted in the eight main hospitals of Niger. These eight hospitals included two
National Referral Hospitals (Lamordé and Zinder) and six Regional Referral Hospitals
(Poudrière, Dosso, Tahoua, Maradi, Diffa and Agadez). Authorization for the review
was given by the Ministry of Health of Niger. Health workers (HW) present during
surveyors’ visits were included in the study. Two (2) specific objectives were
considered: 1) Determine HW perceptions and current use of the Supplemental
Suckling Technique (SST) and 2) Collect HW propositions on feasibility to organize
outpatient treatment of SAM in infants less than six months. Self-designed interview
guide was used. Data were analysed manually and saturation in the occurrence of
responses were the criteria used to retain items. The Supplemental Suckling Technique
(SST), though firmly recommended by national guidelines to ensure continuation of
breastfeeding and adequate nutrients intake from supplemental milks especially in a
small infant, was rarely used. Main reasons advanced by staff were work overload,
inadequate training, and lack of compliance from mothers. Before being discharged
from hospital, mothers were counseled on continuation of treatment, follow up visits at
peripheral health center (PHC) and feeding options at home. However, hospital staff
had no indication whether mothers were seen at the referred PHC, nor if counseling
was practiced at home. The proposed outpatient treatment model for selected cases
without medical complications should relieve hospital caseloads, strengthen referral
and improve breastfeeding support to mothers after discharge from hospital.
Keywords
Malnutrition; infant feeding; inpatient treatment; qualitative assessment; Niger
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