Training Packages and Patient Management Tools for Healthcare Staff Working with Small, Nutritionally At-Risk Infants Aged under 6 Months: A Mixed-Methods Study

Abstract

Skilled staff are essential for successfully managing child malnutrition, especially when dealing with small, nutritionally at-risk infants aged under 6 months. Training and patient management tools provide healthcare workers with core knowledge, skills, and support. To inform more effective future approaches and support the rollout of new WHO wasting prevention/treatment guidelines, we aimed to map and understand globally available training and patient management tools. In a mixed-methods study, we searched the literature to identify different training packages and management tools and conducted semi-structured key informant interviews with staff working in a variety of internationally organizations and settings. Data were analyzed using a phenomenological approach. We found 14 different training packages targeting different settings, including inpatient, outpatient, and humanitarian contexts. Curricula varied, especially around breastfeeding and maternal assessment, mental health, and nutritional status. Key informants (n = 9) reported gaps regarding counseling skills, time for practice, and how to effectively provide mental health counseling. Training delivery was highly dependent on resources and setting. In conclusion, future training should consider setting-specific needs, opportunities, and limitations. Emphasis on breastfeeding-support skills, mental health support, and counseling skills is needed. Enhanced practical sessions, refresher trainings, and ongoing monitoring and support are vital to ensure sustained high-quality services.

Maternal mental health and nutritional status of infants aged under 6 months: a secondary analysis of a cross-sectional survey

“…These could have implication to future integration of MMH care in to the maternal and child health service which are too crowded to ensure adequate assessment, privacy and confidentiality. While there is increasing interest into how to integrate MMH and malnutrition programming (21), screening strategy for MMH in the management of small and nutritionally at-risk infants aged under 6 months and their mothers (MAMI) context may require a unique rather than the routine mental health screening approach to be able to effectively elicit symptoms. In general additional qualitative, epidemiological and experimental studies are essential to understand various circumstances that could explain the current finings to reach on robust conclusion.…”

“…More evidence on this is needed, especially since the new WHO guidelines on malnutrition highlight the need to consider MMH as part of care for infants u6m at risk of poor growth and development (as well as older children(20)). There is increasing interest into how to integrate MMH and malnutrition programming (21) so evidence on this area are essential.…”

Acceptability and Feasibility of Maternal Mental Health Assessment When Managing Small, Nutritionally At-Risk Infants Aged < 6 Months: A Key Informant Interview Study

“…Some participants had designed more efficient MMH screening tools for staff in their settings, so there may be scope for larger scale implementation in the future. These include the screening approach promoted by the MAMI Global Network in the MAMI Clinical Care Pathway for small, nutritionally at-risk infants u6m [41,42]. Although MMH specialist staff may be a valuable investment, many participants felt that MMH specialists are not necessary at all stages of care pathways for effective implementation of MMH assessments.…”