The impact of a short-term intervention using the WHO guidelines for the management of severe malnutrition at a rural facility in Angola.

Giugliani C, Duncan BB, Harzheim E, Breysse S, Jarrige L.

A study has shown that short-term intervention with in-service supervision based on the WHO guidelines in a setting of limited resources contributed to a reduction in fatality rates from severe malnutrition

The study measured the impact of practice review and in-service supervision based on WHO guidelines on outcomes of severely malnourished children in a rural facility with minimal resources staffed only by nurses in a therapeutic feeding centre in rural Angola.

The intervention consisted of weekly physician supervision of staff activities and establishment of a study group composed of nurses in the centre by Médecins Du Monde.

The findings showed that among 379 children admitted during the intervention, compared to the 358 children admitted previously, successful treatment increased from 73.2% to 82.6% (RR 1.13; 95% CI 1.04 to 1.22) and fatalities decreased from 15.6% to 8.7% (RR 0.56; 95% CI 0.37 to 0.83).

The authors concluded that that such guidelines can be effectively implemented in under-resourced facilities in Angola and similar settings if they are introduced using an interactive approach and if in-service supervision continues to be provided, contributing to reduction in fatalities.

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