Comparison of three models of training and supervision with community health workers providing treatment of children with severe acute malnutrition in Mali

Effect of integrating the management of severe acute malnutrition without complications into essential community healthcare with community health workers in the Kita, Kayes and Bafoulabé health districts in Mali

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN14990746

Enrollment

10000

Registered

2018-04-20

Start date

2017-11-01

Completion date

Unknown

Last updated

2025-09-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Malnutrition Nutritional, Metabolic, Endocrine Malnutrition

Interventions

The study is carried out in the three districts of Kayes: Kita, Kayes and Bafoulabe, with similar sociodemographic, cultural and education characteristics. In the three areas SAM treatment will be del

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Aged 6-59 months 2. SAM defined in accordance with the Integrated Management Acute Malnutrition protocol, taking into account one of the following criteria: MUAC <115 mm or bilateral oedema 3. Parents have given their voluntary and informed consent to participate in the study

Exclusion criteria

Exclusion criteria: 1. Complications requiring treatment in a unit for intensive nutritional rehabilitation (URENI) 2. Trips outside of the intervention area

Design outcomes

Primary

Measure	Time frame
1. Percentage of children with MUAC >125 mm 2. Percentage defaulters (children who have missed two consecutive CHW/health facility visits) 3. Percentage of children who die during treatment period Data will be reported on a monthly basis by CHWs and health facilities. The normal length of treatment is 6-8 weeks.	—

Secondary

Measure	Time frame
1. Workload of CHW Time allocation for all three methods, and on the distribution of time between preventative activities and curative activities, as well as the average time required for a CHW to manage a SAM case in all three methods will be recorded. We evaluated the different timetable tools which provide precise estimations of contact time for the health workers. The gold standard for studies on time use is direct observation and study of time allocation with the help of highly qualified observers. However, this method requires enough resources, not only in terms of time required for a sufficient number of observations, but also in terms of qualified staff to carry out these observations, and in terms of local expertise, which is often rare for these methods (and which means recruiting international experts is sometimes required). Previous research suggests that self-administered time logs are an alternative method. It provides estimations of the duration of contact between the health worker and his patients through direct observations. The analysis is expected in July 2018. 2. Cost-effectiveness Any healthcare strategy must take into account costs and effectiveness. A retrospective study will be carried out during the second phase of the project. Data on costs supported by Action Against Hunger will come from Action Against Hunger's accounting statements. The program's other costs, including those supported by the government's healthcare facilities, will be collected through interviews with key informers, conducted by the study coordinator. Costs which are not available through accounting records will be estimated using a method based on ingredients, using unit costs and various input quantities. Household costs will be estimated by discussion groups in each study area. The variation of these costs will be modelled using sensitivity analysis. Interviews regarding timetables will be conducted with most employees involved in the implementation of the p	—

Measure

Time frame

1. Workload of CHW Time allocation for all three methods, and on the distribution of time between preventative activities and curative activities, as well as the average time required for a CHW to manage a SAM case in all three methods will be recorded. We evaluated the different timetable tools which provide precise estimations of contact time for the health workers. The gold standard for studies on time use is direct observation and study of time allocation with the help of highly qualified observers. However, this method requires enough resources, not only in terms of time required for a sufficient number of observations, but also in terms of qualified staff to carry out these observations, and in terms of local expertise, which is often rare for these methods (and which means recruiting international experts is sometimes required). Previous research suggests that self-administered time logs are an alternative method. It provides estimations of the duration of contact between the health worker and his patients through direct observations. The analysis is expected in July 2018. 2. Cost-effectiveness Any healthcare strategy must take into account costs and effectiveness. A retrospective study will be carried out during the second phase of the project. Data on costs supported by Action Against Hunger will come from Action Against Hunger's accounting statements. The program's other costs, including those supported by the government's healthcare facilities, will be collected through interviews with key informers, conducted by the study coordinator. Costs which are not available through accounting records will be estimated using a method based on ingredients, using unit costs and various input quantities. Household costs will be estimated by discussion groups in each study area. The variation of these costs will be modelled using sensitivity analysis. Interviews regarding timetables will be conducted with most employees involved in the implementation of the p

—

Countries

Mali

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 11, 2026