Efficacy and Effectiveness of Community-Based Treatment of Severe Malnutrition

Ashworth, Ann

doi:10.1177/15648265060273s303

Cited by 130 publications

(134 citation statements)

References 39 publications

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“…CHWs play an important role in implementing these programs. Outcomes are similar to those provided exclusively at facilities, but at a much lower cost per child and with much higher levels of population coverage (1,6,8,30,83,152).…”

Section: Reduction Of Undernutritionmentioning

confidence: 75%

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

681

671

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Over the past half-century, community health workers (CHWs) have been a growing force for extending health care and improving the health of populations. Following their introduction in the 1970s, many large-scale CHW programs declined during the 1980s, but CHW programs throughout the world more recently have seen marked growth. Research and evaluations conducted predominantly during the past two decades offer compelling evidence that CHWs are critical for helping health systems achieve their potential, regardless of a country's level of development. In low-income countries, CHWs can make major improvements in health priority areas, including reducing childhood undernutrition, improving maternal and child health, expanding access to family-planning services, and contributing to the control of HIV, malaria, and tuberculosis infections. In many middle-income countries, most notably Brazil, CHWs are key members of the health team and essential for the provision of primary health care and health promotion. In the United States, evidence indicates that CHWs can contribute to reducing the disease burden by participating in the management of hypertension, in the reduction of cardiovascular risk factors, in diabetes control, in the management of HIV infection, and in cancer screening, particularly with hard-to-reach subpopulations. This review highlights the history of CHW programs around the world and their growing importance in achieving health for all.

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Section: Reduction Of Undernutritionmentioning

confidence: 75%

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

681

671

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“…Another review, conducted by Ashworth, et al (5), studied the effectiveness of rehabilitating severely malnourished children in community settings. Effectiveness was defined as mortality of less than 5% or weight gain of more than 5 g/kg/day.…”

Section: Systematic Reviewsmentioning

confidence: 99%

Efficacy and safety of therapeutic nutrition products for home based therapeutic nutrition for severe acute malnutrition: A systematic review

Gera

2010

Indian Pediatr

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“…A commonly cited reason behind this resistance is the supposed persistence of a high risk of mortality after recovery from SAM once the patient has exited the treatment programme (Ashworth, 2006). Data on the longer term mortality associated with discharge from inpatient therapeutic feeding centres is variable; some studies have reported a cumulative mortality rate of 1 to 1.5 years after discharge of up to 41% (Ashworth, 2006;Chapko et al, 1994;Pecoul et al, 1992;Reneman and Derwig, 1997;Roosmalen-Wiebenga et al, 1987), whilst others have reported lower figures of 2.3% after 12 months of follow up, and 4.1% after 1.5 years of follow up (Bahwere et al, 2008;Khanum et al, 1998). An earlier study reported a mortality of 1.5%, 12 months after discharge among children treated using the domiciliary approach (Khanum et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Long term mortality after community and facility based treatment of severe acute malnutrition: Analysis of data from Bangladesh, Kenya, Malawi and Niger

Bahwere¹

2012

J. Public Health Epidemiol.

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The effectiveness of the community based therapeutic care (CTC) in treating severe acute malnutrition (SAM) has been demonstrated. However, there is still resistance from some policy makers and donors to invest into this cost-effective intervention. The mortality rate ratio (MRR) calculated by dividing the observed deaths after discharge by expected deaths was used to compare survival of 1,670 children discharged from the Dowa CTC from August 2002 to May 2005 and that of other cohorts reporting on long term survival of children after treatment of SAM retrieved from literature. A MMR of 1.1 (0.9 to 1.4) was observed for the Dowa CTC cohort while the MMR of 2.7 (1.3 to 4.9), 5.5 (3.9 to 7.6) and 20.0 (11.0 to 33.4) were observed for studies retrieved from the literature. Data showed that the survival of children who defaulted was worse than that of those who were discharged cured, and that of children treated at home after stabilisation or directly was better than those treated as inpatient until exit from the programme. The study outlines the need of using MMR when reporting on long term survival after SAM treatment and suggests that CTC should be included in the package of interventions with high potential for accelerating the progress towards reaching Millennium Developmental Goal four.

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Efficacy and Effectiveness of Community-Based Treatment of Severe Malnutrition

Abstract: Background. There is a long tradition of communitybased rehabilitation for treatment of severe malnutrition: the question is whether it is effective and whether it should be advised for routine health systems.Objective.

Cited by 130 publications

References 39 publications

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Efficacy and safety of therapeutic nutrition products for home based therapeutic nutrition for severe acute malnutrition: A systematic review

Long term mortality after community and facility based treatment of severe acute malnutrition: Analysis of data from Bangladesh, Kenya, Malawi and Niger

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