Evidence map›Paper›PMID 30258650›Full record

ArticlePilot and feasibility studies2018

A mixed methods feasibility study of the Kusamala Program at a nutritional rehabilitation unit in Malawi.

Allison I Daniel, Meta van den Heuvel, Melissa Gladstone, Mike Bwanali, Wieger Voskuijl, Celine Bourdon, Isabel Potani, Sara Fernandes, Jenala Njirammadzi, Robert H J Bandsma

Registry-linked trialAbstract read
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In one paragraph

Article in Pilot and feasibility studies, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03072433 (The Effect of an Intervention Program for Primary Caregivers on the Development of Children With Severe Malnutrition), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03072433 nacompletednot on this map

The Effect of an Intervention Program for Primary Caregivers on the Development of Children With Severe Malnutrition: A Cluster Randomized Controlled Clinical Trial

TypeinterventionalSponsorThe Hospital for Sick ChildrenRan2016 to 2020Enrolled181ConditionsChild MalnutritionArmsCounseling Intervention Package, Standard of Care
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Allison I Daniel1Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario Canada.ORCID 0000-0002-1774-1214
Meta van den Heuvel1Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario Canada.
Melissa Gladstone6Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Mike Bwanali7Moyo Nutritional Rehabilitation and Research Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Wieger Voskuijl8Global Child Health Group, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Celine Bourdon2Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Ontario Canada.
Isabel Potani9Department of Paediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi.
Sara Fernandes6Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Jenala Njirammadzi9Department of Paediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi.
Robert H J Bandsma1Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren admitted to nutritional rehabilitation units (NRUs) for inpatient treatment of severe acute malnutrition (SAM) are at high risk of poor developmental and nutritional outcomes. The Kusamala Program is an interactive hospital-based counseling program for primary caregivers of children with SAM that integrates three modules: nutrition and feeding; water, sanitation, and hygiene (WASH); and psychosocial stimulation. This mixed methods feasibility study aimed to evaluate the implementation of the Kusamala Program in an NRU setting and developmental outcomes in children with SAM 6 months after inpatient treatment.

methodsAn internal pilot trial including the first 30 children and their primary caregivers enrolled to a cluster-randomized controlled trial of the Kusamala Program was performed. Barriers and enablers were identified in a qualitative study with a focus group discussion (FGD) and in-depth interviews (IDIs) with 12 hospital staff members, including five NRU nurses who deliver the Kusamala Program.

resultsResults demonstrated high participant engagement (100%) and adherence (87%) of primary caregivers to the Kusamala Program. Potential barriers to implementation identified through the qualitative study were caregivers' perceived value of the program, prioritization of other ward activities, and shortages of staff. On the other hand, enablers to implementation were engaging other staff members, motivation and work ethic, and refresher training.

conclusionsThis mixed methods study demonstrates the feasibility of implementing the Kusamala Program in a real NRU setting. The full cluster-randomized controlled trial will be completed to evaluate the effectiveness of the Kusamala Program.

trial registrationClinicalTrials.gov, NCT03072433. Registered on 7 March 2017-retrospectively registered.

Indexed as

Child developmentIntegrated interventionsNutritionPsychosocial stimulationSevere acute malnutritionWASH

Identifiers

PMID30258650
PMCPMC6151933

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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.