Abstrait

Bottlenecks and met needs for the treatment of severe acute malnutrition in pastoralists: Doolo zone of somali region, Ethiopia.

Abdifatah Elmi Farah*, Abdulahi Haji Abas, Ahmed Tahir Ahmed

Background : There is high burden of malnutrition worldwide, including wasting that is compromising growth and development of children and nations. In Ethiopia, severe acute malnutrition (SAM) remains a public health problem. Prevalence of acute malnutrition i.e. wasting is highest (22.7%), (17.5 %) in Somali region of Ethiopia. This study assessed the bottlenecks and met needs for SAM treatment coverage in Doolo zone Somali regional state of Ethiopia. Methods : This study used Tanahashi model of service coverage to identify bottlenecks for SAM treatment coverage at health facility platform using multi-stage sampling in Doolo zone, Somali regional state of Ethiopia. Tracer interventions were selected to make the analysis more manageable and systematic. The collected data were entered in to excel then thoroughly cleaned and analysed. Indicators for supply-side, demand and quality were calculated. The shortest bar of the graph was considered as a bottleneck for supply-side while sharp decline or drop-in between one bar of the graph to the next was considered as a bottleneck in demand and quality sides. Performance thresholds were set for the indicators as (Good, fair and poor) and met need for SAM was then calculated. Result : The analysis identified bottlenecks across the six determinants of coverage for the treatment of SAM. Major supply-side bottlenecks identified were commodity stock-outs, mainly ready to use therapeutic foods (RUTF) and shortage of trained health extension workers in three of the four districts studied. On the demand side, despite reasonable initial utilizations in most of the districts studied, there were poor continuity of services (high defaulter rate) and low quality of SAM treatment (effective coverage). The met need was lowest in Bokh district (12%) and highest in Danod district (70%). Despite average treatment coverages of 85% and above for Geladi, Warder and Danod districts, yet the met need was found to be 54%, 60% and 70% respectively which was not commensurate with average treatment coverages.