The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial
Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approa...
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Oxford University Press
2024
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/145096 |
| _version_ | 1855533709905625088 |
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| author | Donfouet, Hermann Pythagore Pierre Daniel, Tewoldeberhan Wilunda, Calistus Mwaniki, Elizabeth Njiru, James Keane, Emily Schofield, Lily Maina, Lucy Kutondo, Edward Agutu, Olivia Okoth, Peter F. Raburu, Judith Samburu, Betty Mwangi, Bonventure Zerfu, Taddese Alemu Khamadi, Jemimah Wekhomba Cuellar, Pilar Charle Kavoo, Daniel Karimurio, Lydia Matanda, Charles Mutua, Alex Gichohi, Grace Chabi, Martin Codjia, Patrick Oteyza, Saul Guerrero Kimani-Murage, Elizabeth |
| author_browse | Agutu, Olivia Chabi, Martin Codjia, Patrick Cuellar, Pilar Charle Daniel, Tewoldeberhan Donfouet, Hermann Pythagore Pierre Gichohi, Grace Karimurio, Lydia Kavoo, Daniel Keane, Emily Khamadi, Jemimah Wekhomba Kimani-Murage, Elizabeth Kutondo, Edward Maina, Lucy Matanda, Charles Mutua, Alex Mwangi, Bonventure Mwaniki, Elizabeth Njiru, James Okoth, Peter F. Oteyza, Saul Guerrero Raburu, Judith Samburu, Betty Schofield, Lily Wilunda, Calistus Zerfu, Taddese Alemu |
| author_facet | Donfouet, Hermann Pythagore Pierre Daniel, Tewoldeberhan Wilunda, Calistus Mwaniki, Elizabeth Njiru, James Keane, Emily Schofield, Lily Maina, Lucy Kutondo, Edward Agutu, Olivia Okoth, Peter F. Raburu, Judith Samburu, Betty Mwangi, Bonventure Zerfu, Taddese Alemu Khamadi, Jemimah Wekhomba Cuellar, Pilar Charle Kavoo, Daniel Karimurio, Lydia Matanda, Charles Mutua, Alex Gichohi, Grace Chabi, Martin Codjia, Patrick Oteyza, Saul Guerrero Kimani-Murage, Elizabeth |
| author_sort | Donfouet, Hermann Pythagore Pierre |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approach to enhancing health outcomes in primary healthcare. This study aimed to assess the effectiveness of integrating the treatment of acute malnutrition by community health volunteers into integrated community case management in two sub-counties in northern Kenya (Loima and Isiolo). We conducted a two-arm non-inferiority cluster-randomized controlled trial across 20 community health units. Participants were children aged 6–59 months with uncomplicated acute malnutrition. In the intervention group, community health volunteers used simplified tools and protocols to identify and treat eligible children at home and provided the usual integrated community case management package. In the control group, community health volunteers provided the usual integrated community case management package only (screening and referral of the malnourished children to the health facilities). The primary outcome was recovery (MUAC ≥12.5 cm for 2 consecutive weeks). Results show that children in the intervention group were more likely to recover than those in the control group [73 vs 50; risk difference (RD) = 26% (95% CI 12 to 40) and risk ratio (RR) = 2 (95% CI 1.2 to 1.9)]. The probability of defaulting was lower in the intervention group than in the control group: RD = −21% (95% CI −31 to −10) and RR = 0.3 (95% CI 0.2 to 0.5). The intervention reduced the length of stay by about 13 days, although this was not statistically significant and varied substantially by sub-county. Integrating the treatment of acute malnutrition by community health volunteers into the integrated community case management programme led to better malnutrition treatment outcomes. There is a need to integrate acute malnutrition treatment into integrated community case management and review policies to allow community health volunteers to treat uncomplicated acute malnutrition. |
| format | Journal Article |
| id | CGSpace145096 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Oxford University Press |
| publisherStr | Oxford University Press |
| record_format | dspace |
| spelling | CGSpace1450962025-12-08T10:11:39Z The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial Donfouet, Hermann Pythagore Pierre Daniel, Tewoldeberhan Wilunda, Calistus Mwaniki, Elizabeth Njiru, James Keane, Emily Schofield, Lily Maina, Lucy Kutondo, Edward Agutu, Olivia Okoth, Peter F. Raburu, Judith Samburu, Betty Mwangi, Bonventure Zerfu, Taddese Alemu Khamadi, Jemimah Wekhomba Cuellar, Pilar Charle Kavoo, Daniel Karimurio, Lydia Matanda, Charles Mutua, Alex Gichohi, Grace Chabi, Martin Codjia, Patrick Oteyza, Saul Guerrero Kimani-Murage, Elizabeth children community involvement malnutrition policy innovation risk Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approach to enhancing health outcomes in primary healthcare. This study aimed to assess the effectiveness of integrating the treatment of acute malnutrition by community health volunteers into integrated community case management in two sub-counties in northern Kenya (Loima and Isiolo). We conducted a two-arm non-inferiority cluster-randomized controlled trial across 20 community health units. Participants were children aged 6–59 months with uncomplicated acute malnutrition. In the intervention group, community health volunteers used simplified tools and protocols to identify and treat eligible children at home and provided the usual integrated community case management package. In the control group, community health volunteers provided the usual integrated community case management package only (screening and referral of the malnourished children to the health facilities). The primary outcome was recovery (MUAC ≥12.5 cm for 2 consecutive weeks). Results show that children in the intervention group were more likely to recover than those in the control group [73 vs 50; risk difference (RD) = 26% (95% CI 12 to 40) and risk ratio (RR) = 2 (95% CI 1.2 to 1.9)]. The probability of defaulting was lower in the intervention group than in the control group: RD = −21% (95% CI −31 to −10) and RR = 0.3 (95% CI 0.2 to 0.5). The intervention reduced the length of stay by about 13 days, although this was not statistically significant and varied substantially by sub-county. Integrating the treatment of acute malnutrition by community health volunteers into the integrated community case management programme led to better malnutrition treatment outcomes. There is a need to integrate acute malnutrition treatment into integrated community case management and review policies to allow community health volunteers to treat uncomplicated acute malnutrition. 2024-08-08 2024-06-10T17:18:47Z 2024-06-10T17:18:47Z Journal Article https://hdl.handle.net/10568/145096 en https://doi.org/10.1371/journal.pgph.0002564 Open Access Oxford University Press Donfouet, Hermann Pythagore Pierre; Daniel, Tewoldeberhan; Wilunda, Calistus; Mwaniki, Elizabeth; Njiru, James; Zerfu, Taddese Alemu; et al. 2024. The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial. Health Policy and Planning 39(7): 710–721. https://doi.org/10.1093/heapol/czae036 |
| spellingShingle | children community involvement malnutrition policy innovation risk Donfouet, Hermann Pythagore Pierre Daniel, Tewoldeberhan Wilunda, Calistus Mwaniki, Elizabeth Njiru, James Keane, Emily Schofield, Lily Maina, Lucy Kutondo, Edward Agutu, Olivia Okoth, Peter F. Raburu, Judith Samburu, Betty Mwangi, Bonventure Zerfu, Taddese Alemu Khamadi, Jemimah Wekhomba Cuellar, Pilar Charle Kavoo, Daniel Karimurio, Lydia Matanda, Charles Mutua, Alex Gichohi, Grace Chabi, Martin Codjia, Patrick Oteyza, Saul Guerrero Kimani-Murage, Elizabeth The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial |
| title | The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial |
| title_full | The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial |
| title_fullStr | The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial |
| title_full_unstemmed | The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial |
| title_short | The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: A cluster-randomized controlled trial |
| title_sort | impacts of task shifting on the management and treatment of malnourished children in northern kenya a cluster randomized controlled trial |
| topic | children community involvement malnutrition policy innovation risk |
| url | https://hdl.handle.net/10568/145096 |
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