Evidence map›Paper›PMID 38836582›Full record

Trial reportHealth policy and planning2024

The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: a cluster-randomized controlled trial.

Hermann Pythagore Pierre Donfouet, Tewoldeberhan Daniel, Calistus Wilunda, Elizabeth Mwaniki, James Njiru, Emily Keane, Lily Schofield, Lucy Maina, Edward Kutondo, Olivia Agutu and 16 more

Abstract readRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in Health policy and planning, 2024. 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
–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.

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.

  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

26 authors.

Hermann Pythagore Pierre DonfouetThe World Bank Health Nutrition and Population Global Practice, 1818 H Street, NW, Washington, DC 20433, United States.
Tewoldeberhan DanielUNICEF Kenya, UNICEF Eastern and Southern Africa Regional Office, Nairobi 44145, Kenya.
Calistus WilundaAfrican Population and Health Research Center, APHRC Campus, Kitisuru, Nairobi 10787-00100, Kenya.
Elizabeth MwanikiAfrican Population and Health Research Center, APHRC Campus, Kitisuru, Nairobi 10787-00100, Kenya.
James NjiruSave the Children International, 3rd Floor ABC Place Waiyaki Way, Westlands Box 19423, Nairobi 00202 KNH, Kenya.
Emily KeaneSave the Children UK, St Vincent House, 30 Orange Street, London WC2H 7HH, United Kingdom.
Lily SchofieldSave the Children UK, St Vincent House, 30 Orange Street, London WC2H 7HH, United Kingdom.
Lucy MainaUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Edward KutondoUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Olivia AgutuUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Peter OkothUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Judith RaburuUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Betty SamburuUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Bonventure MwangiAfrican Population and Health Research Center, APHRC Campus, Kitisuru, Nairobi 10787-00100, Kenya.
Taddese Alemu ZerfuAfrican Population and Health Research Center, APHRC Campus, Kitisuru, Nairobi 10787-00100, Kenya.
Jemimah Wekhomba KhamadiAction Against Hunger-Kenya, Nairobi 39900-00623, Kenya.
Pilar Charle CuellarAction Against Hunger, 6 Mitre Passage, London SE10 0ER, United Kingdom.
Daniel KavooMinistry of Health, Nairobi 30016-00100, Kenya.
Lydia KarimurioMinistry of Health, Nairobi 30016-00100, Kenya.
Charles MatandaMinistry of Health, Nairobi 30016-00100, Kenya.
Alex MutuaMinistry of Health, Nairobi 30016-00100, Kenya.
Grace GichohiMinistry of Health, Nairobi 30016-00100, Kenya.
Martin ChabiWorld Health Organization, U-Block, Third floor, United Nations Office, Nairobi 45335, Kenya.
Patrick CodjiaUNICEF Kenya, UNICEF Kenya Country Office, Nairobi 44145-00100, Kenya.
Saul Guerrero OteyzaUNICEF Headquarters, Maiden Lane, New York, NY 10038, United States.
Elizabeth Kimani-MurageAfrican Population and Health Research Center, APHRC Campus, Kitisuru, Nairobi 10787-00100, Kenya.

Funding

American Express FoundationChildren's Investment Fund FoundationUnited States Agency for International DevelopmentWorld Health Organization 001
6 · The paper itself

Abstract

Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approach to enhancing health outcomes in primary healthcare. This study aimed to assess the effectiveness of integrating the treatment of acute malnutrition by community health volunteers into integrated community case management in two sub-counties in northern Kenya (Loima and Isiolo). We conducted a two-arm non-inferiority cluster-randomized controlled trial across 20 community health units. Participants were children aged 6-59 months with uncomplicated acute malnutrition. In the intervention group, community health volunteers used simplified tools and protocols to identify and treat eligible children at home and provided the usual integrated community case management package. In the control group, community health volunteers provided the usual integrated community case management package only (screening and referral of the malnourished children to the health facilities). The primary outcome was recovery (MUAC ≥12.5 cm for 2 consecutive weeks). Results show that children in the intervention group were more likely to recover than those in the control group [73 vs 50; risk difference (RD) = 26% (95% CI 12 to 40) and risk ratio (RR) = 2 (95% CI 1.2 to 1.9)]. The probability of defaulting was lower in the intervention group than in the control group: RD = -21% (95% CI -31 to -10) and RR = 0.3 (95% CI 0.2 to 0.5). The intervention reduced the length of stay by about 13 days, although this was not statistically significant and varied substantially by sub-county. Integrating the treatment of acute malnutrition by community health volunteers into the integrated community case management programme led to better malnutrition treatment outcomes. There is a need to integrate acute malnutrition treatment into integrated community case management and review policies to allow community health volunteers to treat uncomplicated acute malnutrition.

Indexed as

Child Nutrition DisordersCommunity Health WorkersTask ShiftingCase ManagementChild, PreschoolCommunity Health ServicesFemaleHumansInfantKenyaMalechild malnutritioncommunity health volunteersnon-inferiority cluster-randomized controlled trialTask shifting

Identifiers

PMID38836582
PMCPMC11308611

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.