Peer-reviewed article
Barriers and Factors Associated With Treatment Coverage of Severe Acute Malnutrition Among Children 6-59 Months in Agrarian and Pastoralist Areas of Ethiopia.
Bayise Biru, Lieven Huybregts, Dessalegn Tamiru, Mohammed Areb, Alemayehu Haddis et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A screening study in two regions of Ethiopia found that only 12.8% of children aged 6-59 months with severe acute malnutrition were receiving treatment. The main barriers were lack of awareness about the child's malnutrition, time and money constraints, and family permission issues. Wealthier households, access to water treatment, recent screening campaigns, nearby health services, and vaccination card possession were associated with higher treatment rates.
Key points
- Treatment coverage for severe acute malnutrition was only 12.8% in both agrarian and pastoralist areas
- Top barriers included lack of awareness of nutritional status, time constraints, financial constraints, and absence of family permission
- Household wealth was strongly associated with treatment coverage (adjusted prevalence ratio 2.9)
- Recent community MUAC screening was the strongest factor associated with treatment access (adjusted prevalence ratio 12.0)
- Availability of treatment services at nearby health posts increased coverage (adjusted prevalence ratio 3.2)
Limitations
The study describes associations rather than causal relationships. The findings are limited to two woredas in Ethiopia and may not generalise to other regions with different contexts.
Abstract
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-specific interventions. A door-to-door screening campaign among children aged 6-59 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%-17.9%). 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: 1.5-5.5), use of water treatment methods (aPR: 4.6; 95% CI: 1.7-11.9), recent community MUAC screening (aPR: 12.0; 95% CI: 5.4-26.8), availability of treatment services at a nearby health post (aPR: 3.2; 95% CI: 1.1-9.9), and possession of a vaccination card (aPR: 3.2; 95% CI: 1.1-9.1) 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. Trial Registration: ClinicalTrials.gov (NCT06380504).