Process evaluation of severe acute malnutrition program for under-five admitted children at stabilization center in Wag-Himra Zone public hospitals, Northeast Ethiopia 2023.

Abstract

Background: Despite the existence of standard protocol, many stabilization centers (SCs) continue to experience high mortality of children receiving treatment for severe acute malnutrition. Evidence showed that in Wag-Himra zone, children with complicated severe acute malnourished who were admitted, mortality was greater than the minimum SPHERE (<10%) criteria for stabilization facilities. The government of Ethiopia stabilization center program endorsed into the health system provides inpatient treatment of malnutrition. So the study aimed to assess the implementation status of severe acute malnutrition program at stabilization center in Wag-Himra zone public hospitals. Methods: A single case study with a concurrent mixed method was used to evaluate the process of severe acute malnutrition program for under-five admitted children at stabilization center in Wag-Himra Zone public hospitals from April 8 -10th of June 2023. A total of 27 indicators were used to evaluate the availability, compliance and acceptability dimensions of the program. The resource inventory, 9 Key informant interview, 30 client provider interactions observations, 384 document reviews and 422 mother/caregivers’ interview were done. Bivariable and multivariable logistic regression analysis were done to identify predictor variables associated with acceptability. Adjusted Odds Ratio (AOR) with 95% CI, & p-value <0.05 used to declare statically significant variable. Result: The overall implementation status of the stabilization center was 77.61% which was measured by availability (92.4%), compliance (81.04%), & acceptability (62.58%) dimensions. The caregiver occupation (AOR=0.51, 95%CI: 0.27.0.98), rural residence (AOR=0.53, 95% CI (0.32-0.88)), drinkable water access in facility (AOR=0.62, 95%CI: 0.41-0.94) were stastically associated with acceptability of stabilization center program. Conclusion and recommendation: The evaluation of the implementation status of program was judged good. No safe drinking water, Resomal, not appetite test done for admitted children, and half of the children’s medical history and physical examination were not recorded that hinder the implementation status of severe acute malnutrition program at stabilization center.so health provider adhered to treatment guideline of malnutrition