ArticleArchives of disease in childhood2007
WHO guidelines for severe malnutrition: are they feasible in rural African hospitals?
Article in Archives of disease in childhood, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Dysglycemia in Children with Severe Acute Malnutrition: A Systematic Review and Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2021Pooled it
- Psychosocial stimulation interventions for children with severe acute malnutrition: a systematic review.Journal of global health · 2017Pooled it
- Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process.BMC public health · 2013Pooled it
- [Hospital management of severe acute malnutrition in children with F-75 and F-100 alternative local preparations: results and challenges].The Pan African medical journal · 2015Trial
- Exploring current barriers and enablers of severe acute malnutrition management among children (6-59 months): perspectives from health professionals in northern Ghana.BMC nutrition · 2025Article
- Healthcare providers' implementation of severe acute malnutrition guidelines and the factors associated with it among healthcare providers working at public health facilities of South Wollo Zone, Northeast Ethiopia, in 2024.Health research policy and systems · 2025Article
- Acceptability and feasibility of integrating psychosocial stimulation interventions in the inpatient care of children with severe acute malnutrition in resource-poor settings: a qualitative study.Journal of nutritional science · 2024Article
- Factors influencing the implementation of severe acute malnutrition guidelines within the healthcare referral systems of rural subdistricts in North West Province, South Africa.PLOS global public health · 2023Article
- Evaluating the role of breastfeeding peer supporters' intervention on the inpatient management of malnourished infants under 6 months in Kenyan public hospitals.International breastfeeding journal · 2022Article
- Scaling Up Improved Inpatient Treatment of Severe Malnutrition: Key Factors and Experiences From South Africa, Bolivia, Malawi, and Ghana.Global health, science and practice · 2022Review
- Implementing effective eLearning for scaling up global capacity building: findings from the malnutrition elearning course evaluation in Ghana.Global health action · 2020Article
- Improved care and survival in severe malnutrition through eLearning.Archives of disease in childhood · 2020Article
- Predictors of in-hospital mortality among under-five children with severe acute malnutrition in South-Western Uganda.PloS one · 2020Article
- A quantitative cross-sectional survey of psychosocial stimulation and counselling interventions at nutritional rehabilitation units in Southern Malawi.Malawi medical journal : the journal of Medical Association of Malawi · 2019Article
- Effectiveness of the Malnutrition eLearning Course for Global Capacity Building in the Management of Malnutrition: Cross-Country Interrupted Time-Series Study.Journal of medical Internet research · 2018Article
- Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals.African journal of primary health care & family medicine · 2018Article
- Outcomes of children aged 6-59 months with severe acute malnutrition at the GADO Outpatient Therapeutic Center in Cameroon.BMC research notes · 2018Article
- A mixed methods feasibility study of the Kusamala Program at a nutritional rehabilitation unit in Malawi.Pilot and feasibility studies · 2018Article
- Observational
- Experience: developing an inpatient malnutrition checklist for children 6 to 59 months to improve WHO protocol adherence and facilitate quality improvement in a low-resource setting.Global health action · 2018Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo assess the feasibility of implementing and sustaining the WHO guidelines for inpatient management of severe malnutrition in under-resourced rural South African hospitals, and to identify any constraints.
interventionThree 2-day training workshops were held in 1998, followed by monthly 1-day visits for 5 months, ending in March 1999, in two rural district hospitals with limited resources in Eastern Cape Province, South Africa.
methodsA 12-month observational study was conducted from April 2000 to April 2001 in Mary Theresa and Sipetu hospitals (Eastern Cape Province, South Africa), including 1011 child-hours of observation on the wards, medical record reviews, interviews with carers and staff, and inventories of essential supplies. All admissions (n = 193) for severe malnutrition to the two hospitals were studied. The main outcomes were the extent to which the 10 steps for routine care of severely malnourished children were implemented, proficiency of performance and constraining factors.
resultsThe hospitals made the changes required in clinical and dietary management, but the tasks were not always performed fully or with sufficient care. Play and stimulation and an effective system of follow-up were not implemented. Doctors' poor knowledge, nurses' inattentiveness and insufficient interaction with carers were constraints to optimal management. The underlying factors were inadequate undergraduate training, understaffing, high doctor turnover and low morale.
conclusionsGuidelines for severe malnutrition are largely feasible but training workshops are insufficient to achieve optimal management as staff turnover and an unsupportive health system erode the gains made and doctors treat cases without having being trained. Medical and nursing curricula in Africa must include treatment of severe malnutrition.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.