Table 5 Synthesis of findings obtained from the use of the adapted WHO six building blocks
Theme | Key findings | |
|---|---|---|
Facilitating factors | Challenging factors | |
Nutrition governance | -Nutrition is a priority for the government | -Nutrition coordination not fully under government leadership |
-Child nutrition policy developed | ||
-CMAM is part of the nutrition strategic interventions in the country | -CMAM training not yet included in the curriculum of medical schools | |
-Inpatient and outpatient CMAM guidelines developed and disseminated | ||
Nutrition Financing | -Primary health care service free of charge for under- 5 children | -Most of CMAM funds provided by donors, and for short term interventions |
-Funds dedicated to nutrition and CMAM available | ||
Health and Nutrition Service Delivery | -Primary health care activities delivered in the health facilities, including growth monitoring and promotion programme | -Screening and management of acute malnutrition not delivered in the health centres, and not included into outreach health activities |
-Outreach health activities performed by community clinics health workers | ||
Human resources | -Available staff adequate in numbers to cover the caseload of inpatient management of SAM children with complications | -Health workers not trained for adequate identification and management of acute malnutrition |
-Insufficient number of health facility staff to handle outpatient SAM and MAM caseloads | ||
-Health workers not willing to work in rural areas | ||
Equipment and supply | -Presence of consultation rooms in the inpatient and outpatient health centres | -Absence of dedicated spaces for children in the hospitals |
-Presence of medical material in good working condition | -Absence or inadequate latrines and water sources | |
-Available kitchen facilities in the inpatient health centres | -Lack of anthropometric materials | |
-Absence of play areas and toys for children | ||
-Kitchen facilities not well equipped | ||
-Inadequate storage facilities | ||
-Absence of paediatric wards | ||
-Insufficient supply of medicines | ||
-Absence of therapeutic and supplementary foods | ||
Referral, monitoring and supervision mechanism | -Existence of a functional reporting mechanism | -Absence of a formal referral mechanism |
-Existence of a regular supervision | -Nutrition indicators not included in the health information system | |