Coverage of Community-Based Management of Severe Acute Malnutrition Programmes in Twenty-One Countries, 2012-2013
Coverage of Community-Based Management of Severe Acute Malnutrition Programmes in Twenty-One Countries, 2012-2013
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DOI：
10.1371/journal.pone.0128666
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发表时间：
2015-06-04
期刊：
影响因子：
3.7
通讯作者：
Alvarez, Jose Luis
中科院分区：
文献类型：
--
作者：
Rogers, Eleanor;Myatt, Mark;Alvarez, Jose Luis
目的回顾2012年7月至2013年6月收集的严重急性营养不良（SAM）治疗方案的覆盖数据。这是一项描述性研究，通过对覆盖监测网络支持的21个国家的社区SAM治疗方案的覆盖评估收集覆盖水平和覆盖障碍。审查了44项覆盖率评估的数据。这些评估分析了6至59个月大的营养不良人群，以了解急性营养不良治疗服务的可及性和覆盖率。大多数摊款来自撒哈拉以南非洲。结果大多数项目（44个项目中的33个）未能达到具体情况下国际商定的最低覆盖标准。在这项分析中，各方案实现的估计覆盖率的平均水平为38.3%。最常见的获取障碍是缺乏对营养不良的认识、缺乏对方案的认识、高机会成本、方案间接口问题以及以前的拒绝。本研究表明，cam的覆盖率低于之前对早期CTC计划的分析；因此减少方案影响。需要解决获取服务的障碍，以便通过更加重视某些活动，如社区宣传，开始改善覆盖面。由于障碍是相互关联的，把重点放在具体活动上，例如将服务分散到卫星站点，可能会大大增加营养服务的利用。规划需要确保持续监测障碍，以确保及时清除和扩大覆盖范围。
ObjectiveThis paper reviews coverage data from programmes treating severe acute malnutrition (SAM) collected between July 2012 and June 2013.DesignThis is a descriptive study of coverage levels and barriers to coverage collected by coverage assessments of community-based SAM treatment programmes in 21 countries that were supported by the Coverage Monitoring Network. Data from 44 coverage assessments are reviewed.SettingThese assessments analyse malnourished populations from 6 to 59 months old to understand the accessibility and coverage of services for treatment of acute malnutrition. The majority of assessments are from sub-Saharan Africa.ResultsMost of the programmes (33 of 44) failed to meet context-specific internationally agreed minimum standards for coverage. The mean level of estimated coverage achieved by the programmes in this analysis was 38.3%. The most frequently reported barriers to access were lack of awareness of malnutrition, lack of awareness of the programme, high opportunity costs, inter-programme interface problems, and previous rejection.ConclusionsThis study shows that coverage of CMAM is lower than previous analyses of early CTC programmes; therefore reducing programme impact. Barriers to access need to be addressed in order to start improving coverage by paying greater attention to certain activities such as community sensitisation. As barriers are interconnected focusing on specific activities, such as decentralising services to satellite sites, is likely to increase significantly utilisation of nutrition services. Programmes need to ensure that barriers are continuously monitored to ensure timely removal and increased coverage.