Infant malnutrition treatment in Kenya: Health worker and breastfeeding peer supporter experiences.
Infant malnutrition treatment in Kenya: Health worker and breastfeeding peer supporter experiences.
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DOI：
10.1111/mcn.13148
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发表时间：
2021-07
影响因子：
3.4
通讯作者：
Jones C
中科院分区：
文献类型：
--
作者：
Chabeda S;Oluoch D;Mwangome M;Jones C
6个月以下婴儿的急性营养不良越来越被认为是一个全球性的公共卫生问题。世界卫生组织（WHO）关于6岁以下婴儿住院营养康复的指南是再哺乳：重新建立纯母乳喂养。有证据表明，这些指导方针在许多低收入环境中很少得到遵守。在肯尼亚沿海地区的三家公立医院进行的两项婴儿营养康复研究雇用了母乳喂养同伴支持者，以促进世卫组织准则的实施。为了探讨该策略对卫生工作者（HWs）和BFPs的可接受性，对三家研究医院的20名HWs和5名BFPs进行了深入访谈。卫生工作者报告说，BFPS的存在改变了婴儿营养康复的管理方式，增加了重新哺乳的努力，减少了对补充牛奶的依赖。据说，BFP有助于解决工作人员短缺问题，并有专门的时间来支持和帮助母亲。BFPs成功的关键是他们能够与母亲建立社会关系，因为他们的经历和背景相似。尽管基本建设筹资和社会保障系统取得了成功，但人力资源管理和基础设施方面的挑战依然存在。可成功地利用BFP促进实施卫生组织关于肯尼亚医院中6岁以下严重营养不良婴儿营养康复的准则，与严重营养不良婴儿的母亲建立支持性社会关系和信任，并帮助解决人力资源短缺问题。
Acute malnutrition in infants under 6 months (u6m) is increasingly recognised as a global public health problem. The World Health Organisation (WHO) guidelines for inpatient nutritional rehabilitation of infants u6m is re‐lactation: the re‐establishment of exclusive breastfeeding. Evidence suggests these guidelines are rarely followed in many low‐income settings. Two studies of infant nutritional rehabilitation undertaken in three public hospitals in coastal Kenya employed breastfeeding peer supporters (BFPSs) to facilitate WHO guideline implementation. To explore the acceptability of the strategy to health workers (HWs) and the BFPSs, in‐depth interviews were conducted with 20 HWs and five BFPSs in the three study hospitals. The HWs reported that the presence of the BFPSs changed the way infant nutritional rehabilitation was managed, increasing efforts at relactation and decreasing reliance on supplemental milk. BFPSs were said to help address staff shortages and had dedicated time to support and assist the mothers. Key to the success of the BFPSs was the social relationships they were able to establish with the mothers due to the similarity in their experiences and backgrounds. Despite the success of the BFPSs, human resource management and infrastructure challenges remained. BFPSs can successfully be employed to facilitate the implementation of the WHO guidelines for the nutritional rehabilitation of acutely malnourished infants u6m in hospitals in Kenya, establishing supportive social relationships and trust with the mothers of the acutely malnourished infants and helping to address the issue of human resource shortages.
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