{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T12:09:39Z","timestamp":1744114179852},"reference-count":19,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T00:00:00Z","timestamp":1509062400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980017002610_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To assess the quality of care provided by lady health workers (LHW) managing cases of uncomplicated severe acute malnutrition (SAM) in the community.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017002610_abs2\" sec-type=\"general\"><jats:title>Design<\/jats:title><jats:p>Cross-sectional quality-of-care study.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017002610_abs3\" sec-type=\"general\"><jats:title>Setting<\/jats:title><jats:p>The feasibility of the implementation of screening and treatment for uncomplicated SAM in the community by LHW was tested in Sindh Province, Pakistan. An observational, clinical prospective multicentre cohort study compared the LHW-delivered care with the existing outpatient health facility model.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017002610_abs4\" sec-type=\"subjects\"><jats:title>Subjects<\/jats:title><jats:p>LHW implementing treatment for uncomplicated SAM in the community.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017002610_abs5\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Oedema was diagnosed conducted correctly for 87\u00b75 % of children; weight and mid upper-arm circumference were measured correctly for 60\u00b70 % and 57\u00b74 % of children, respectively. The appetite test was conducted correctly for 42\u00b70 % of cases. Of all cases of SAM without complications assessed during the study, 68\u00b70 % received the correct medical and nutrition treatment. The proportion of cases that received the correct medical and nutrition treatment and key counselling messages was 4\u00b70 %.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017002610_abs6\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>This quality-of-care study supports existing evidence that LHW are able to identify uncomplicated SAM, and a majority can provide appropriate nutrition and medical treatment in the community. However, the findings also show that their ability to provide the complete package with an acceptable level of care is not assured. Additional evidence on the impact of supervision and training on the quality of SAM treatment and counselling provided by LHW to children with SAM is required. The study has also shown that, as in other sectors, it is essential that operational challenges are addressed in a timely manner and that implementers receive appropriate levels of support, if SAM is to be treated successfully in the community.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980017002610","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T13:37:34Z","timestamp":1509111454000},"page":"385-390","update-policy":"http:\/\/dx.doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Quality of care of treatment for uncomplicated severe acute malnutrition provided by lady health workers in Pakistan"],"prefix":"10.1017","volume":"21","author":[{"given":"Eleanor","family":"Rogers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahid","family":"Fazal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saul","family":"Guerrero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imtiaz","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajid","family":"Soofi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Luis","family":"Alvarez Mor\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2017,10,27]]},"reference":[{"key":"S1368980017002610_ref16","unstructured":"Alvarez JL , Dent N , Browne L et al. (2016) Putting Child Kwashiorkor on the Map. http:\/\/www.ennonline.net\/childkwashiorkor (accessed October 2017)."},{"key":"S1368980017002610_ref9","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.0.0205"},{"key":"S1368980017002610_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2012.00409.x"},{"key":"S1368980017002610_ref17","volume-title":"Evaluation of the Effectiveness and Impact of Community Case Management of Severe Acute Malnutrition Through Lady Health Workers as Compared to a Facility Based Program: Cluster Randomized Controlled Trial","author":"Hussain","year":"2017"},{"key":"S1368980017002610_ref10","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-12-340"},{"key":"S1368980017002610_ref11","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.04.020403"},{"key":"S1368980017002610_ref14","doi-asserted-by":"crossref","unstructured":"Alvarez Mor\u00e1n JL , Al\u00e9 FB , Rogers E et al. (2017) Quality of care for treatment of uncomplicated severe acute malnutrition delivered by community health workers in a rural area of Mali. Matern Child Nutr (Epublication ahead of print version).","DOI":"10.1111\/mcn.12449"},{"key":"S1368980017002610_ref15","volume-title":"Facility Survey: Tool to Evaluate the Quality of Care Delivered to Sick Children Attending Outpatient Facilities","year":"2003"},{"key":"S1368980017002610_ref19","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2012.12-0030"},{"key":"S1368980017002610_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980014002444"},{"key":"S1368980017002610_ref2","unstructured":"UNICEF (2015) Annual Results Report: Nutrition. https:\/\/www.unicef.org\/publicpartnerships\/files\/2015ARR_Nutrition.pdf (accessed March 2015)."},{"key":"S1368980017002610_ref13","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.13-0751"},{"key":"S1368980017002610_ref18","unstructured":"Sphere Project (2011) The Sphere Handbook, 3rd ed. http:\/\/www.sphereproject.org (accessed March 2017)."},{"key":"S1368980017002610_ref4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0128666"},{"key":"S1368980017002610_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czr038"},{"key":"S1368980017002610_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12198"},{"key":"S1368980017002610_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69443-9"},{"key":"S1368980017002610_ref7","volume-title":"WHO\/UNICEF Joint Statement: Integrated Community Case Management (iCCM)","year":"2012"},{"key":"S1368980017002610_ref1","unstructured":"UNICEF, World Health Organization & The World Bank Group (2016) Joint Child Malnutrition Estimates \u2013 Levels and Trends (2016 edition). http:\/\/www.who.int\/nutgrowthdb\/estimates2015\/en\/ (accessed February 2017)."}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1368980017002610","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,5]],"date-time":"2019-10-05T07:40:52Z","timestamp":1570261252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1368980017002610\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,27]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["S1368980017002610"],"URL":"https:\/\/doi.org\/10.1017\/s1368980017002610","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"value":"1368-9800","type":"print"},{"value":"1475-2727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,27]]},"assertion":[{"value":"Copyright \u00a9 The Authors 2017\u00a0This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}