ArticleNutrients2022
Key Challenges to Optimal Therapeutic Coverage and Maternal Utilization of CMAM Program in Rural Southern Pakistan: A Qualitative Exploratory Study.
Article in Nutrients, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 23 citations in OpenAlex.
- Barriers and Factors Associated With Treatment Coverage of Severe Acute Malnutrition Among Children 6-59 Months in Agrarian and Pastoralist Areas of Ethiopia.Maternal & child nutrition · 2026Article
- Experiencing modular adaptive decentralized water security systems in southern Pakistan and implications for public health and nutrition: a qualitative exploratory study.Frontiers in public health · 2026Article
- Suicide and Self-Harming Among Young Women: A Qualitative Exploratory Study in Southern Punjab, Pakistan.Healthcare (Basel, Switzerland) · 2025Article
- Role of Maternal Empowerment in Addressing Child Malnutrition: Evidence from Asian Developing Countries.Children (Basel, Switzerland) · 2025Article
- Exploring the Potential Causal Relationship Between Health Insurance Coverage and Child Nutritional Status in Pakistan: Evidence from PDHS-2018.Healthcare (Basel, Switzerland) · 2025Article
- An exploratory study on midwives' perceptions of the availability of preconception care in health facilities in the Kpandai District of Northern Ghana.PLOS global public health · 2025Article
- The law of diminishing marginal returns in health insurance: evidence on child health outcomes from Pakistan's Sehat Sahulat program.Frontiers in public health · 2025Article
- Estimating program coverage in the treatment of acute malnutrition using population-based cluster survey methods: results from surveys in Burkina Faso, Chad, Democratic Republic of the Congo, and Niger.Frontiers in public health · 2025Article
- Political Economy of Maternal Child Malnutrition: Experiences about Water, Food, and Nutrition Policies in Pakistan.Nutrients · 2024Article
- "An obedient wife never says "no" to her virtual god." High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study.BMC public health · 2024Article
- Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan.Children (Basel, Switzerland) · 2024Article
- Experience of caregivers on the continuum of care and prevention of malnutrition among children with cholera in Ethiopia: a phenomenology study.BMC public health · 2024Article
- Time to recovery and its predictors among children aged 6-59 months having uncomplicated severe acute malnutrition attending an outpatient therapeutic program in Northeast Ethiopia: prospective cohort study.Frontiers in nutrition · 2024Article
- Impact of Drinking Water Source and Sanitation Facility on Malnutrition Prevalence in Children under Three: A Gender-Disaggregated Analysis Using PDHS 2017-18.Children (Basel, Switzerland) · 2022Article
- Comparison of Different Nutritional Screening Approaches and the Determinants of Malnutrition in Under-Five Children in a Marginalized District of Punjab Province, Pakistan.Children (Basel, Switzerland) · 2022Article
- Distance to Healthcare Facility and Lady Health Workers' Visits Reduce Malnutrition in under Five Children: A Case Study of a Disadvantaged Rural District in Pakistan.International journal of environmental research and public health · 2022Article
- Rural mothers' beliefs and practices about diagnosis, treatment, and management of children health problems: A qualitative study in marginalized Southern Pakistan.Frontiers in public health · 2022Article
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Severe Acute Malnutrition (SAM) is a serious public health problem in many low- and middle-income countries (LMICs). Therapeutic programs are often considered the most effective solution to this problem. However, multiple social and structural factors challenge the social inclusion, sustainability, and effectiveness of such programs. In this article, we aim to explore how poor and remote households face structural inequities and social exclusion in accessing nutrition-specific programs in Pakistan. The study specifically highlights significant reasons for the low coverage of the Community Management of Acute Malnutrition (CMAM) program in one of the most marginalized districts of south Punjab. Qualitative data are collected using in-depth interviews and FGDs with mothers and health and nutrition officials. The study reveals that mothers' access to the program is restricted by multiple structural, logistical, social, and behavioral causes. At the district level, certain populations are served, while illiterate, and poor mothers with lower cultural capital from rural and remote areas are neglected. The lack of funding for nutrition causes the deprioritization of nutrition by the health bureaucracy. The subsequent work burden on Lady Health Workers (LHWs) and the lack of proper training of field staff impact the screening of SAM cases. Moreover, medical corruption in the distribution of therapeutic food, long distances, traveling or staying difficulties, the lack of social capital, and the stigmatization of mothers are other prominent difficulties. The study concludes that nutrition governance in Pakistan must address these critical challenges so that optimal therapeutic coverage can be achieved.
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