Peer-reviewed article
Primary healthcare readiness for nutritionally at-risk infants aged under 6 months: a facility-based survey in Senegal.
Tabitha D van Immerzeel, Indou Deme-Ly, Maty Diagne-Camara, Rebecca E Penzias, Daouda Seck et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study assessed how ready primary healthcare facilities in Senegal are to identify and manage malnutrition in infants under 6 months old. Researchers surveyed 15 facilities using an adapted assessment tool that looked at infrastructure, equipment, training, and clinical practices across five contact points in the health system. While basic infrastructure and workforce were reasonably available, significant gaps were found in equipment and staff training, with only about one-third of at-risk infants being properly classified and treated according to WHO guidelines.
Key points
- General facility readiness was 69.5%, but MAMI (care for small and nutritionally at-risk infants) readiness was only 37.7%
- Infrastructure scored well at 72.0% and health workforce at 60.7%, but equipment was very low at 32.5% and training at only 22.3%
- Only 15.2% of infants assessed as at-risk were actually classified as such, and only 38.2% received adequate treatment
- Delivery and sick child clinics showed highest readiness, while immunization clinics had highest patient utilization
- Multiple contact points in the health system offer opportunities to implement WHO-recommended nutritional care for infants under 6 months
Limitations
This is a facility-based survey that assesses readiness and existing practices but does not evaluate the impact of any interventions on infant health outcomes. The findings are from 15 facilities in Senegal and may not reflect the situation across all primary care settings nationally or regionally.
Abstract
BACKGROUND: Malnutrition in infants aged <6 mo (u6m) is poorly identified and managed in many countries, increasing the risk of poor growth and development. Addressing this gap, 2023 WHO malnutrition guidelines recommend assessment, classification and treatment at primary care level. This study aimed to assess primary healthcare facility readiness for nutritional care in infants u6m. METHODS: We adapted the Harmonized Health Facility Assessment (HHFA), adding items for Management of small and nutritionally At-risk Infants u6m and their Mothers (MAMI) at five care contact points. Our HHFA-MAMI tool captured 342 items using healthcare provider interviews, observations and registers data to calculate mean scores per area and median patient visits. RESULTS: We surveyed 15 facilities in Senegal. General readiness scored 69.5%, MAMI availability and readiness 37.7%. Infrastructure (72.0%) and health workforce (60.7%) were available, while equipment (32.5%) and training (22.3%) scored low. Infants were frequently assessed (53.6%), not often classified (15.2%) as at risk, nor adequately treated (38.2%). Comparing contact points, delivery and sick child clinic scored highest in readiness, immunization in utilization. CONCLUSIONS: Primary care readiness gaps exist in classifying and treating at-risk infants u6m, equipment and training. We found opportunities at each of the five contact points to implement WHO-recommended care.