Madinani: A Win Against Malnutrition
Tata Doumbia undergoing a malnutrition check via measuring MUAC (mid upper arm circumference) with a Shakir strip during home visit rounds.
In Q3, Muso conducted training in Madinani for approximately 100 healthcare professionals for the treatment of child malnutrition. In Côte d'Ivoire, the Madinani district has extraordinarily high rates of childhood malnutrition, which can be attributed to gaps in provider training and the limited availability of treatment. - The last training that health personnel in the district received on diagnosis and treatment of child malnutrition took place four years ago. Given that public health center staff in Côte d'Ivoire typically shift their posts every two years, the majority of current staff are untrained in these essential protocols. To address this gap, Muso provided financial and technical support, and facilitated two training sessions in August for clinic personnel and CHWs. These sessions aimed to train healthcare staff and CHWs on diagnosing malnutrition cases, particularly being able to distinguish between moderate and severe malnutrition, and on administering WHO approved treatment supplements, such as Plumpy Nut and Plumpy Sup.
Through advocacy efforts with the Ivorian government, Muso succeeded in securing authorization for CHWs to address malnutrition directly within the community, a practice that had not been previously permitted in national protocols. While the National Program for Nutrition (PNN) was not fundamentally opposed to community-based malnutrition treatment, they did recall past experiences where CHWs had misdiagnosed certain malnutrition cases. The PNN’s stance was strongly influenced by the World Health Organization’s (WHO) emphasis on the greater accuracy of diagnosing malnutrition based on weight and height measurements, due to potential inaccuracies associated with the Shakir strip (there may exist a slight margin of error, particularly when it indicates a yellow result), which can only be conducted at the health center level.
In Q3 an agreement was reached between Muso and the PNN, which stipulates that CHWs can treat malnutrition cases within the community, but they must first report cases to primary health care centers. Following confirmation of diagnosis at a health center, the CHW can then provide life saving supplements to treat the child directly within the community. This new approach removes geographic and infrastructure barriers and reduces delays for children who require this critical treatment.