Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

Vitamin A supplement: a key strategy to prevent vitamin A deficiency among young children in Afghanistan

Background:Vitamin A deficiency is the main problem of public health worldwide demonstrated that 190 million population of preschool children and 122 countries(in Africa and South-East Asia)have vitamin A deficiency,according to recent estimated research.In Afghanistan,vitamin A supplementation is a key strategy to prevent vitamin A deficiency among young children.Children receive vitamin A supplements as part of National Immunization Days(NID)campaigns.Methods:In this case study,the data was collected from June 15/2015 to February 23/2016,and the final report of the Afghanistan Demographic Health Survey(AfDHS)2015 was released on February 15/2017.All 27,209 children aged 6-59 months who are living with their mothers were included in this study.Who consumed foods rich in vitamin A was not included in this study.Results:The percentages who were given vitamin A supplements in the last 6 months among all children 6-59 months aged.A total of 1,572 children aged among 6-8 months were given vitamin A supplements 670(42.6%)children and comparison with the total community of the study(27,209)children(2.46%).A total of 1,148 children aged among 9-11 months were given vitamin A supplements to 465(40.5%)children and comparison with the total community of the study(27,209)children(1.70%).Conclusion:After following up on more studies,we found that vitamin A deficiency is a public problem,thus it is better to use wheat flour fortification,vitamin A capsule(VAC)supplementation,nutrition education,source of vitamin A,and training of primary healthcare workers on the clinical to prevent and treat the vitamin A deficiency among children.Therefore,we aimed to determine the given vitamin A supplementation among children aged 6-59 months in 33 provinces in Afghanistan,in 2015.