Research Improving the case definition of small and nutritionally at-risk infants under six months of age and their mothers in Senegal

Growth failure in infants from 0 to 6 months: health facility opportunities for better  care in Senegal

In global action to reduce maternal and child malnutrition, infants from birth to six months have been left behind in public health interventions ¹. In this so-called “exclusive breastfeeding window” around one in five infants suffers from growth failure in a recent review in 54 high- prevalence countries². Nutritional deficits during this phase of rapid growth and development increase risk of mortality³, poor development ⁴ and chronic diseases later in life⁵.

Although in most countries routine care such as vaccination and growth monitoring takes place for young infants, those with growth failure are often not detected and fall through the cracks of the health system⁶. A novel Care Pathway has been developed to bridge this gap in detection and care, using a community-focussed, outpatient approach, including (breast)feeding counselling, and close follow-up⁷.

This research project aims to identify health facility opportunities to implement the MAMI Care Pathway in Senegal. We use primary health facility cross- sectional survey, assessing current detection and care for nutrition and growth in infants from 0 to 6 months in Senegal as well as interviews and focus group discussions with stakeholders, to assess feasibility of the MAMI Care Pathway in the context of Senegal.

We expect that results of this study will inform health workers and policy makers of opportunities for better care for growth infant failure in Senegal and beyond. 

References:

1. Park JJH, Fang ML, Harari O, et al. Association of Early Interventions With Birth Outcomes and Child Linear Growth in Low-Income and Middle-Income Countries: Bayesian Network Meta-analyses of Randomized Clinical Trials. JAMA Netw Open 2019; 2(7): e197871.
2. Kerac M, Frison S, Connell N, Page B, McGrath M. Informing the management of acute malnutrition in infants aged under 6 months (MAMI): risk factor analysis using nationally-representative demographic & health survey secondary data. PeerJ 2019; 6: e5848.
3. Grijalva-Eternod CS, Kerac M, McGrath M, et al. Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis. Matern Child Nutr 2017; 13(3).
4. Walker SP, Wachs TD, Gardner JM, et al. Child development: risk factors for adverse outcomes in developing countries. The lancet 2007; 369(9556): 145-57.
5. Grey K, Gonzales GB, Abera M, et al. Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review. BMJ Glob Health 2021; 6(3).
6. Kerac M, Mwangome M, McGrath M, Haider R, Berkley JA. Management of acute malnutrition in infants aged under 6 months (MAMI): Current issues and future directions in policy and research. Food and Nutrition Bulletin 2015; 36(1).
7. Network MG. MAMI Care Pathway Package. https://www.ennonline.net/attachments/4004/MAMI-Care-Pathway-Package-Document-_07June2021.pdf, 2021.