Increasing the Coverage of Severe Acute Malnutrition (SAM) Treatment in Ethiopia
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: R-SWITCH integrated intervention package.
- Кому может быть актуально
- Состояния в реестре: Acute Malnutrition, Severe, Malnutrition, Child, Wasting. Базовые параметры: 6 мес. — 5 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Ethiopia
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Effect of Leveraging Community-level Structures to Strengthen Prevention, Screening and Treatment of Severe Acute Malnutrition in Ethiopia
Обзор
The R-SWITCH intervention aims to address the low coverage of treatment for severe wasting (SAM) by leveraging existing community groups to deliver an integrated package focused on prevention, screening, referral, and treatment of SAM. It includes behavior change communication on child nutrition and health, active screening, improved passive screening at health posts, and follow-up of referred cases and those enrolled in outpatient treatment programs (OTP). The primary objectives of the R-SWITCH studies are to assess the intervention's impact on OTP coverage, identify implementation barriers and facilitators, and evaluate its cost-efficiency and cost-effectiveness.
Подробное описание
Despite the high mortality risk of severe wasting (also referred to as severe acute malnutrition or SAM), only a small proportion of children with severe wasting are currently identified and admitted to available outpatient treatment programs (OTP). In 2020, an estimated 4.9 million children with severe wasting received treatment, approximately a third of the total burden. Outside of humanitarian settings, this proportion is even lower (estimated to be around 15%). These figures highlight the urgent need to increase treatment coverage to meet the Sustainable Development Goals (SDG), which aim to reduce the prevalence of child wasting to less than 5% by 2025 and less than 3% by 2030. The continuum of care for SAM, from case identification, referral to treatment, and post-treatment follow-up, is hampered by several barriers including caregiver lack of awareness on the risks and treatment services of SAM, stigma related to SAM, poor accessibility to treatment, frequent stockouts of treatment inputs, and the overall workload faced by first-line health workers.
The R-SWITCH intervention will leverage existing community groups to deliver an integrated package aimed at preventing SAM through behavior change communication (BCC) on child nutrition and health, increasing wasting screening coverage through active screening, family-led MUAC and improved passive screening health posts, increasing treatment coverage through follow-up of earlier referred cases, cases enrolled in OTP, and children who completed OTP and recovered.
The primary objectives of the R-SWITCH studies are:
* To assess the impact of the R-SWITCH intervention on SAM OTP coverage * To identify implementation barriers and facilitators * To assess the cost-efficiency and cost-effectiveness of the intervention package and services
Вмешательства
- Поведенческое R-SWITCH integrated intervention package
1. Monthly group meetings of Alliance for Development (AFD) community groups) and their members (caregivers of children 0-59 months of age): * Introduction and refresher of Family-led MUAC * Active screening of wasting by AFD * Group SBCC on Infant and Young Child Feeding (IYCF), health and Water, Sanitation and Hygiene (WaSH) with a focus on SAM * Promotion of health services such as GMP 2. Introduction of weight-for-age Z-score \<-3 as screening criterion for passive screening by
Первичные конечные точки
- Period prevalence of SAM OTP treatment coverage in children 6-59 months of age [Срок оценки: After 24 months of program implementation]
Вторичные конечные точки (12)
- Point prevalence of SAM OTP treatment coverage in children 6-59 months of age [Срок оценки: After 24 months of program implementation]
- Period prevalence of SAM OTP treatment coverage in the subgroup of treatment eligible children 6-59 months of age [Срок оценки: After 24 months of program implementation]
- Screening coverage of SAM [Срок оценки: After 24 months of program implementation]
- Screening coverage of severe underweight [Срок оценки: After 24 months of program implementation]
- Platform specific screening coverage of SAM [Срок оценки: After 24 months of program implementation]
- Growth Monitoring Promotion (GMP) consultation attendance [Срок оценки: After 24 months of program implementation]
- AFD group meeting attendance [Срок оценки: After 24 months of program implementation]
- AFD home visit coverage [Срок оценки: After 24 months of program implementation]
- Prevalence of SAM [Срок оценки: After 24 months of program implementation]
- Prevalence of wasting [Срок оценки: After 24 months of program implementation]
- Prevalence of stunting [Срок оценки: After 24 months of program implementation]
- Prevalence of underweight and severe underweight [Срок оценки: After 24 months of program implementation]
Критерии участия
Критерии включения
- Child 6-59 months of age
- Suffering from SAM (defined as MUAC < 115mm or presence of bilateral pitting edema or Weight-for-Length Z-score <-3) OR currently enrolled in SAM OTP
Критерии исключения
\- Anthropometric malformation or being handicapped which hampers anthropometric measurements.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Да
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Открытое
- Основная цель
- Организация здравоохранения
Центры проведения
Ethiopia · 1 центр
- Kersa and Jeldessa woredas — Jimma
Публикации
- Biru B, Huybregts L, Tamiru D, Areb M, Haddis A, Fall T, Toure M, Belachew T. Barriers and Factors Associated With Treatment Coverage of Severe Acute Malnutrition Among Children 6-59 Months in Agrarian and Pastoralist Areas of Ethiopia. Matern Child Nutr. 2026 Jul;22(3):e70219. doi: 10.1111/mcn.70219. PMID 42381597
Идентификаторы
NCT: NCT06380504 · RSWITCH-Ethiopia