{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:46:29Z","timestamp":1792057589776,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Severe acute malnutrition remains a major public health concern, yet a large proportion of affected children do not receive appropriate treatment. Understanding the barriers and associated factors is essential for informing targeted, context\u2010specific interventions. A door\u2010to\u2010door screening campaign among children aged 6\u201359 months was conducted from May to September 2024 in Kersa (agrarian) and Jeldessa (pastoralist) woredas of Ethiopia. The treatment coverage of severe acute malnutrition was 12.8% (95% CI: 9.0%\u201317.9%). The most frequently reported barriers to treatment included lack of awareness of the child's nutritional status, time and financial constraints, and absence of family permission. Multivariable analysis revealed that household wealth index (aPR: 2.9; 95% CI: 1.5\u20135.5), use of water treatment methods (aPR: 4.6; 95% CI: 1.7\u201311.9), recent community MUAC screening (aPR: 12.0; 95% CI: 5.4\u201326.8), availability of treatment services at a nearby health post (aPR: 3.2; 95% CI: 1.1\u20139.9), and possession of a vaccination card (aPR: 3.2; 95% CI: 1.1\u20139.1) were significantly associated with severe acute malnutrition treatment coverage. The findings highlight that severe acute malnutrition treatment coverage in both pastoralist and agrarian settings of Ethiopia remains critically low. Stronger implementation of active screening and treatment services recommended by Ethiopian national guidelines, together with social protection measures for the poorest households, may improve treatment coverage.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    ClinicalTrials.gov (NCT06380504).\n                  <\/jats:p>","DOI":"10.1111\/mcn.70219","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:19:42Z","timestamp":1782915582000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers and Factors Associated With Treatment Coverage of Severe Acute Malnutrition Among Children 6\u201359 Months in Agrarian and Pastoralist Areas of Ethiopia"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-9379","authenticated-orcid":false,"given":"Bayise","family":"Biru","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health Sciences Jimma University Jimma Oromia Ethiopia"},{"name":"School of Public health, Institute of Health sciences Wallaga University Nekemte Oromia Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieven","family":"Huybregts","sequence":"additional","affiliation":[{"name":"Nutrition, Diets, and Health Unit International Food Policy Research Institute (IFPRI) Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dessalegn","family":"Tamiru","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health Sciences Jimma University Jimma Oromia Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Areb","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health Sciences Jimma University Jimma Oromia Ethiopia"},{"name":"College of Medicine and Health sciences Haramaya University Dire Dawa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemayehu","family":"Haddis","sequence":"additional","affiliation":[{"name":"Department of Environmental science and Technology Jimma University Jimma Oromia Ethiopia"},{"name":"Ethiopian Public Health Association  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talla","family":"Fall","sequence":"additional","affiliation":[{"name":"Nutrition, Diets, and Health Unit International Food Policy Research Institute (IFPRI) Dakar Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariama","family":"Tour\u00e9","sequence":"additional","affiliation":[{"name":"Nutrition, Diets, and Health Unit International Food Policy Research Institute (IFPRI) Dakar Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5455-9457","authenticated-orcid":false,"given":"Tefera","family":"Belachew","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health Sciences Jimma University Jimma Oromia Ethiopia"},{"name":"Ethiopian Public Health Association  Addis Ababa Ethiopia"},{"name":"Ethiopian Midwives Association  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173578"},{"issue":"2612","key":"e_1_2_9_3_1","first-page":"1","article-title":"Key Challenges to Optimal Therapeutic Coverage and Maternal Qualitative Exploratory Study","volume":"14","author":"Ahmed F.","year":"2022","journal-title":"Nutrients 2022"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-016-0149-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0299575"},{"key":"e_1_2_9_6_1","unstructured":"Alliance for Child Protection in Humanitarian Action.2019. Minimum Standards for Child Protection in Humanitarian Action 2019 Edition.https:\/\/spherestandards.org\/wp-content\/uploads\/CPMS-2019-EN.pdf."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2025.112852"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-18-00105"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12198"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980015000440"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.9790\/0853-1509012225"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"David Jr. W. H. andR. X. S.Stanley Lemeshow.2013. Applied Logistic Regression (John Wiley & Sons (ed.); 3rd ed. Vol. 85 Issue 411.https:\/\/doi.org\/10.2307\/2290035.","DOI":"10.2307\/2290035"},{"key":"e_1_2_9_13_1","unstructured":"EPHI.2023. National Food and Nutrition Strategy Baseline Survey: Key Findings Priliminary Report.https:\/\/reliefweb.int\/report\/ethiopia\/national-food-and-nutrition-strategy-baseline-survey-key-findings-preliminary-report."},{"key":"e_1_2_9_14_1","unstructured":"FAO UNHCR UNICEF WFP & W.2020. Global Action Plan on Child Wasting.https:\/\/www.who.int\/publications\/m\/item\/global-action-plan-on-child-wasting-a-framework-for-action."},{"key":"e_1_2_9_15_1","volume-title":"Ministry of Health National Guideline for the Management of Acute Malnutrition in Ethiopia","author":"FMOH, G. of E","year":"2019"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2023.07.020"},{"key":"e_1_2_9_17_1","unstructured":"GOAL.2019. The State of Acute Malnutrition The Family MUAC Approach: COOPI in DRC The State of Acute Malnutrition.https:\/\/www.nutritioncluster.net\/sites\/nutritioncluster.com\/files\/2025-02\/2019_SoAM-GOAL-Casestudy-Familly\u00a0MUAC\u00a0in\u00a03\u00a0contexts_EN.pdf."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1513567"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4791-9"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-018-0356-7"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2024.49.38.36956"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-067592"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064636"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980014002444"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0128666"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105017"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026449"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.70054"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7150-1"},{"key":"e_1_2_9_30_1","unstructured":"UNICEF.2021. Integration of Wasting Treatment Into Routine Health Services.https:\/\/www.unicef.org\/media\/109311\/file\/IntegratingEarly Detection and Treatment of Child Wasting into Routine Primary Health Care Services: A RESOURCE GUIDE TO SUPPORT NATIONAL PLANNING.pdf."},{"key":"e_1_2_9_31_1","unstructured":"UNICEF\/WHO\/World Bank Group.2025. Levels and Trends in Child Malnutrition: Key Findings of the 2025 Edition (pp. 1\u201324).https:\/\/data.unicef.org\/wp-content\/uploads\/2025\/07\/JME-Brochure-UNSDG-regions-2025-v23.pdf?client_id=18581918.1760449705&session_id=1173170390."},{"key":"e_1_2_9_32_1","unstructured":"United Nations Systems Standing Committee on Nutrition (UNSCN).2017. By 2030 End All Forms of Malnutrition and Leave No One Behind (pp. 1\u201332).https:\/\/www.unnutrition.org\/sites\/default\/files\/2024-02\/By\u00a02030\u00a0End\u00a0Malnutrition-EN-WEB.pdf."},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czl029"},{"key":"e_1_2_9_34_1","unstructured":"WHO.2023a. Identification of Severe Acute Malnutrition Requiring Inpatient Care in Children 6\u201359 Months of Age.https:\/\/www.who.int\/tools\/elena\/interventions\/sam-identification-inpatient."},{"key":"e_1_2_9_35_1","unstructured":"WHO.2023b. WHO Guideline on the Prevention and Management of Wasting and Nutritional Oedema (Acute Malnutrition) in Infants and Children Under 5 Years. 1\u2013188.https:\/\/files.magicapp.org\/guideline\/a3fe934f-6516-460d-902f-e1c7bbcec034\/published_guideline_7330-1_1.pdf."},{"key":"e_1_2_9_36_1","unstructured":"WHO.2024. Malnutrition.https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/malnutrition."}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70219","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.70219","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:01:46Z","timestamp":1792054906000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/mcn.70219"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70219","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70219"}}