Evidence map›Paper›PMID 36854587›Full record

Observational studyBMJ open2023

Existing gaps and missed opportunities in delivering quality nutrition services in primary healthcare: a descriptive analysis of patient experience and provider competence in 11 low-income and middle-income countries.

Marwa Ramadan, Tonny B Muthee, Latifat Okara, Cameron Feil, Manuela Villar Uribe

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 23% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Article
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

5 authors at 1 institution in 1 country.

Marwa RamadanHealth, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA marwa.eldesoky1987@gmail.com.ORCID 0000-0003-4953-7346
Tonny B MutheeHealth, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA.
Latifat OkaraHealth, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA.ORCID 0000-0002-3015-6749
Cameron FeilHealth, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA.ORCID 0000-0002-9689-7240
Manuela Villar UribeHealth, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA.ORCID 0000-0003-3386-4414
World Bank Group · US

Funding

Gates Foundation INV-000932
6 · The paper itself

Abstract

objectivesTo assess the competence of primary healthcare (PHC) providers in delivering maternal and child nutrition services at the PHC level and patients' experience in receiving the recommended components of care.

designObservational cross-sectional analysis.

settingHealthcare facilities in low/middle-income countries (LMICs) with available service provision assessment surveys (Afghanistan (2018), Democratic Republic of Congo (2018), Haiti (2017), Kenya (2010), Malawi (2013-2014), Namibia (2009), Nepal (2015), Rwanda (2007), Senegal (2018), Tanzania (2015) and Uganda (2007).

participants18 644 antenatal visits and 23 262 sick child visits in 8458 facilities across 130 subnational areas in 11 LMICs from 2007 to 2019. OUTCOMES: (1) Provider competence assessed as the direct observations of actions performed during antenatal care (ANC) and sick child visits; and (2) patients' experience defined as the self-reported awareness of the nutrition services received during ANC and sick child visits and provider effectiveness in delivering these services.

resultsExcept for DRC, all countries scored below 50% on patients' experience and provider competence. More than 70% of clients were advised on taking iron supplements during pregnancy; however, less than 32% of patients were advised on iron side effects in all the studied countries. Across all countries, providers commonly took anthropometric measurements of expectant mothers and children; however, such assessments were rarely followed up with advice or counselling about growth patterns. In addition, less than 20% of observed providers advised on early/immediate breast feeding in all countries with available data.

conclusionThe 11 assessed countries demonstrated the delivery of limited nutrition services; nonetheless, the apparent deficiency in the extent and depth of questions asked for the majority of tracer activities revealed significant opportunities for improving the quality of nutrition service delivery at the PHC level.

Indexed as

Developing CountriesIronChildCross-Sectional StudiesFemaleHumansPatient Outcome AssessmentPregnancyPrimary Health CareIronNutritionPRIMARY CAREPUBLIC HEALTHQuality in health care

Identifiers

PMID36854587
PMCPMC9980366
OpenAlexW4322588584

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.