Malnutrition
52 million children under 5 years of age are wasted, 17 million are severely wasted and 155 million are stunted. Additionally, around 45% of deaths among children under 5 are linked to malnutrition, mostly occurring in Low and Middle Income Countries (WHO 2018). The effects of malnutrition on children and their families are lasting.
Proactively assessing the nutritional status of children under 5, beginning directly after birth, can help target interventions needed for proper child development and survival.
Proper, timely treatments and increased coordination between CHWs and health facilities can improve rehabilitation from acute malnutrition, which in turn has a strong correlation to maternal and newborn survival. Community Health Toolkit application is setup to assist health workers in identifying and referring severe or moderately malnourished children by integrating MUAC screenings & nutrition counselling into existing child health touch points.
The CHT Application malnutrition workflow seeks to accomplish the following:
- Support Assessment and Identification of malnourished children
- Aid in referral of suspected malnourished children to health facility
- Ensure on-time follow up of children on different treatment programs for adherence counselling
- Tasks for monthly screening for all children under 5 years
- Guided screening to ensure adherence to MoH
- Malnutrition protocols
- Referral follow up tasks for referred patients
- Link between facility enrollment and community follow ups
- CHW follow up tasks for treatment defaulters identified at health facility
- Dashboards to monitor Malnutrition related activities and outcomes
- Supportive supervision ratings to identify gaps and mentorship opportunities
- Register all children under 5 years
- Regularly screen all children under 5 years for malnutrition
- Refer any suspected cases to a health facility
- Follow up all referred cases to ensure facility attendance
- Follow up all cases enrolled on treatment to ensure adherence
- Trace any treatment defaulters and return them to care
- Identify all malnourished cases in the community
- All identified malnourished children are treated
- All children on treatment adhere to treatment
Assumptions
- CHWs aware of the screening protocol
- Facilities are sufficiently stocked with nutrition supplements
- CHWs are equipped with functional phones
- CHWs have community trust and good relationship with community
Reduce prevalence of malnutrition and malnutrition related deaths in the community
Once a hierarchy of people and places is established, forms are added at different levels. This diagram indicates the forms that can be filled about a person in the app (in this case, family members at the household level), as well as the person/user who will access these forms and make the reports (CHWs at the CHW Area level). Some forms are accessible as actions from the family member’s profile as actions, others from the CHW’s task list as tasks, and some as either.
Malnutrition workflows are defined to connect form actions and data with people. Detailed documentation for these forms and task schedules are linked from the workflow diagrams below. Accompanying this documentation are tips and insights into the design decisions made along the way, and suggestions for how and where to customize the forms.
