ArticleHuman resources for health2022
Scaling severe acute malnutrition treatment with community health workers: a geospatial coverage analysis in rural Mali.
Article in Human resources for health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Combining Treatment of Acute Malnutrition With Integrated Community Case Management: A Cluster-Randomised Controlled Trial (SETiPlus).Maternal & child nutrition · 2026Trial
- Cost-effectiveness of decentralising acute malnutrition treatment with a standard or simplified treatment protocol: an economic evaluation in the region of Gao, Mali.BMC public health · 2025Trial
- Effectiveness of decentralizing outpatient acute malnutrition treatment with community health workers and a simplified combined protocol: a cluster randomized controlled trial in emergency settings of Mali.Frontiers in public health · 2024Trial
- Reducing relapses after acute malnutrition treatment: evidence from a simplified approach in emergency settings of Mali.Frontiers in public health · 2026Article
- Outcomes of community-based nutrition support groups in Dioila Health District, Mali.Frontiers in nutrition · 2026Article
- Updated fine-scale location data for Blantyre district collected using a low-cost approach.Scientific data · 2025Article
- Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic.Maternal & child nutrition · 2025Article
- Integration of Acute Malnutrition Treatment Into Integrated Community Case Management in Three Districts in Southern Mali: An Economic Evaluation.Global health, science and practice · 2024Article
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2015, the Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated Community Case Management (iCCM). This paper aims to analyze the impact of including community health workers (CHWs) as treatment providers outside the Health Facilities (HFs) on the coverage of SAM treatment when scaling up the intervention in the three largest districts of the Kayes Region in Mali.
methodsA baseline coverage assessment was conducted in August 2017 in the three districts before the CHWs started treating SAM. The end-line assessment was conducted one year later, in August 2018. Coverage was assessed by the standardized methodology called Semi-Quantitative Evaluation of Access and Coverage (SQUEAC). The primary outcome was treatment coverage and other variables evaluated were the geographical distribution of the HFs, CHW's sites and overlapping between both health providers, the estimation of children with geographical access to health care and the estimation of children screened for acute malnutrition in their communities.
resultsTreatment coverage increased in Kayes (28.7-57.1%) and Bafoulabé (20.4-61.1%) but did not in Kita (28.4-28.5%). The decentralization of treatment has not had the same impact on coverage in all districts, with significant differences. The geospatial analyses showed that Kita had a high proportion of overlap between HFs and/or CHWs 48.7% (39.2-58.2), a high proportion of children without geographical access to health care 70.4% (70.1-70.6), and a high proportion of children not screened for SAM in their communities 52.2% (51.9-52.5).
conclusionsWorking with CHWs in SAM increases treatment coverage, but other critical aspects need to be considered by policymakers if this intervention model is intended to be scaled up at the country level. To improve families' access to nutritional health care, before establishing decentralized treatment in a whole region it must be considered the geographical location of CHWs. This previous assessment will avoid overlap among health providers and ensure the coverage of all unserved areas according to their population densities need.
trial registrationISRCTN registry with ID 1990746. https://doi.org/10.1186/ISRCTN14990746.
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