Factors associated with adherence to feeding protocols in stabilization phase of severe acute malnutrition management: Kamuzu Central Hospital, Lilongwe
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Date
2021-11-11
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Kamuzu University of Health Sciences
Abstract
A retrospective cohort study design utilizing quantitative method will be conducted. During the
process, every fourth case file of 6 to 59 months old SAM children admitted in four years from
2017 to 2021 will be selected till 459 sample size is reached. Later those selected files will be
reviewed.
Severe acute malnutrition remains a global challenge affecting 16.6 million out of 238 million
under-five malnourished children and thus representing 7% with a death rate of 5% annually.
Most of SAM cases are highly prevalent in Asia, Sub-Saharan Africa and Haiti in Latin America
because the nation was hit by cholera epidemics which led to economic collapse. Asia has 12
million SAM children and thus representing a larger morbidity and mortality rate compared to
other regions. Malawi through the study done at Kamuzu Central Hospital showed 9.7% of 6 to
36 months old SAM children with a death rate of 10.1%. Despite Malawi having done a lot to
review community-based management of acute malnutrition guidelines and training of health
workers on the same, there are still increased deaths in children with SAM. Again, there is
inadequate data on adherence to SAM treatment, hence the need to do the study.
The study aims at assessing factors associated with level of adherence to feeding protocols of
severely malnourished under-five years of age children at KCH. The specific objectives will be:
to determine adherence level to feeding protocols in the stabilization phase, to establish
association between shift times and adherence, to expose association between days of the week
and adherence, to establish association between wards of admission and adherence and
determine association between outcome and adherence.
A retrospective cohort design will be used to review all 6 to 59 months SAM children case files
from 2017 to 2021. KCH, a tertiary referral hospital in Lilongwe, the Capital of Malawi which
serves patients from nine district hospitals in the Central Region, will be used. The pediatric
ward will be the exact place to do the study. A systematic sampling will be done where every
fourth [1740/459] case file will be selected till the sample size is reached. Data collection will
be done by using data extraction sheet which has six sections A, B, C, D, E and F. The form has
both dependent variables to define adherence and independent variables against which adherence
will be quantified. Descriptive statistics will be used for socio-demographic and clinical
characteristics of the patients. The level of adherence to feeding protocol will be calculated by
using the measures of relative frequency. Univariable and multivariable logistic regression
analysis will be used to assess the association between adherence and each independent variable.
Association between prognosis and adherence level will be established by Chi-square/Fisher’s
Exact test to find the proportion. Data will be presented in graphs, tables, stem and leaf formats.
Expected findings will include: proportion of adherence level, the differences in association
between levels of adherence and independent variables and the level of association between
prognosis and adherence level. Dissemination will be through morning reports, conference
presentation and journal publication. A copy of the dissertation will be sent to Kamuzu
University of Health Sciences, COMREC, KCH and Malawi College of Health Sciences
libraries for reference.
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Research Subject Categories::SOCIAL SCIENCES