Barriers to adequate nutrition care for child malnutrition in a low-resource setting: Perspectives of health care providers

Abstract

IntroductionSeveral studies in developing countries found that more need-based training is required for health care providers (HCPs) in child malnutrition management.MethodsAn exploratory cross-sectional study was conducted to explore barriers to providing adequate nutrition care as perceived by the healthcare providers (HCPs) in the child malnutrition clinic at a Children's University Hospital in Egypt. Participants were selected using the purposive sampling technique. Five out of seven HCPs in the clinic were included (two male physicians, one female physician, and two female nurses). Qualitative data were collected through in-depth interviews. The interview guide consisted of semi-structured open-ended questions. Quantitative data were the resulting scores from the scoring system used to assess the understandability and actionability of the patient education materials (PEMs) that are available in the clinic. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) for the scoring. Statistical analysis: The thematic content analysis technique was employed for qualitative data. The percent score was generated for the PEM actionability and understandability for quantitative data.ResultsMost common child malnutrition conditions encountered by HCPs were nutritional deficiencies. Barriers to the delivery of adequate nutrition care to children were physician-centered: limited nutrition education in the medical school, health system-centered: an insufficient number of HCPs, lack of nutritional supplements, lack of patient education materials (PEMs) that suit the characteristics of the served community, lack of updated standard of practice (SOP) and guidelines, inadequate nutrition training of HCPs, and insufficient time for each patient, and caregivers-centered: the low socioeconomic status and false cultural, nutritional beliefs.ConclusionThere are different barriers to adequate nutrition care for child malnutrition in low-resource healthcare settings. Mainly nutritional deficiencies. Most of the barriers were health system-related in the form of insufficient resources (shortage of workforce; concerning the high caseload, nutritional supplements, and PEMs) and inadequate management of resources (lack of skill-based training, lack of updated SOP and guidelines, and lack of properly designed PEMs that facilitate communication with the target caregivers).

Global disability-adjusted life years and deaths attributable to child and maternal malnutrition from 1990 to 2019

“…The number of doctors per thousand population is the main index used to measure the development of medical human resources in the region. A larger number of doctors per thousand population means more adequate medical human resources, greater possibilities for residents to get medical help, and a reduced incidence of disease burden ( 52 ). Therefore, expanding coverage of care during childbirth and early postpartum can significantly reduce neonatal mortality in this environment, benefiting the poorest and underserved groups.…”

Child undernutrition and its association with household environmental conditions in Bangladesh

“…In LMICs, child undernutrition emerges from a complex interplay of factors, including socio-economic conditions, maternal nutritional status, children's age, birth weight, birth order and family size [7,8]. It is also in uenced by inadequate access to nutritious food, poor breastfeeding, dietary and caregiving practices [9,10], parents' inadequate knowledge about healthy rearing of children [9,11] and compromised healthcare [12]. In light of these multifaceted determinants, reducing child undernutrition, i.e., stunting, wasting and underweight, in LMICs requires a holistic approach that not only addresses these known factors but also delves into the less explored aspects of this challenge.…”

Enhancing the health supply chain for non-communicable diseases management in Rwanda: A qualitative exploration of the perceptions from policy implementers.

“…NCDs account for approximately 17 million premature deaths annually worldwide, with a staggering 86% of these occurring in LMICs (1). Despite global efforts to combat malnutrition, both acute and chronic malnutrition continue to increase in Sub-Saharan Africa (SSA) (2)(3)(4). Unfortunately, the availability of NCD medicines and nutrition products to individual patients remains inadequate in LMICs.…”

“…Unfortunately, the availability of NCD medicines and nutrition products to individual patients remains inadequate in LMICs. This lack of access increases the risk of undermining the effectiveness of healthcare services and hinders progress toward achieving target 3.8 of the Sustainable Development Goals (SDGs), which is related to attaining Universal Health Coverage (UHC) (3,5,6).…”