ArticleHealth research policy and systems2025
Healthcare providers' implementation of severe acute malnutrition guidelines and the factors associated with it among healthcare providers working at public health facilities of South Wollo Zone, Northeast Ethiopia, in 2024.
Article in Health research policy and systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Development and Validation of a Nurse-Specific Scale to Assess Influencing Factors in Clinical Practice Guideline Implementation: An i-PARIHS-Based Study.Journal of nursing management · 2026Article
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6 authors.
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Abstract
backgroundHealth workers must implement severe acute malnutrition (SAM) guidelines to provide quality services for acutely malnourished children. Healthcare providers must adhere to the national severe acute malnutrition guidelines while treating patients. However, limited data are available on the healthcare providers' implementation of severe acute malnutrition guidelines and the contributing factors in Ethiopia. Previous research on the topic focused on document reviews and small sample size. Therefore, this study aims to investigate the implementation of severe acute malnutrition guidelines and the factors associated with it among healthcare providers working in public health facilities in South Wollo Zone, Northeast Ethiopia, in 2024.
methodsA facility-based cross-sectional study was conducted from 1 March to 30 April 2024. Data were collected from 611 randomly selected healthcare providers using an observation checklist and structured questionnaire and using a multi-stage sampling technique. Data entry was done using EpiData version 4.6, and data were exported to SPSS version 27 for analysis. Logistic regression was utilized to identify factors affecting the implementation of severe acute malnutrition guidelines. In bivariable analysis, variables with a P-value less than 0.2 were considered for multivariable analysis. The significance level was determined in the final multivariable analysis on the basis of the adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a P-value of less than 0.05.
resultsA total of 611 healthcare providers were included in the study, resulting in a 92.6% response rate. The study revealed that 62% (95% CI 58.2, 66.1) of healthcare providers implemented the severe acute malnutrition guidelines effectively. Factors such as training on guidelines (AOR = 7.49; 95% CI 4.29, 13.08), the presence of guidelines in the work room (AOR = 3.87; 95% CI 2.38, 6.33) and the job satisfaction of healthcare providers (AOR = 2.3; 95% CI 1.32, 4.03) were determinants associated with healthcare providers' implementation of the severe acute malnutrition guidelines.
conclusionsLess than two thirds of healthcare providers successfully implemented severe acute malnutrition guidelines. This will contribute to further complications, increased default rates, longer stays on treatment and poor SAM treatment outcomes. Factors that influenced the implementation of these guidelines included job satisfaction among healthcare providers, training on guideline updates and the availability of guidelines in the workplace. Healthcare providers working on SAM treatment should implement SAM guidelines according to the guideline standards to improve better outcomes of SAM treatment. To improve adherence to severe acute malnutrition guidelines, district health offices, zonal health departments and regional health bureaus should provide training on the guidelines, distribute printed copies and implement various staff motivation strategies.
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