THE COMMUNITY-BASED MANAGEMENT OF ACUTE MALNUTRITION (CMAM) PROGRAMME: IMPLEMENTATION REALITIES IN THE SAVELUGU NANTON MUNICIPALITY OF NORTHERN GHANA.

Abstract

Child survival remains one of the most important public health challenges in Ghana. The implementation of Community-based Management of Acute Malnutrition (CMAM) is one of the key strategies to improve child survival. The aim of this study was to assess the implementation realities of Community-based Management of Acute Malnutrition programme on child survival in Savelugu/Nanton Municipal of the Northern Region of Ghana. The specific objectives are: 1. Assessing the CMAM service provision in the district. 2. To determine the quality and level of access of CMAM services in the district. 3. To assess factors associated with the poor performance of CMAM services in the District. 4. To solicit for ways of improving CMAM services in the District. A community based descriptive cross-sectional survey was carried out and a systematic random sampling technique was employed to select the study participants for the study. A total of 249malnourished children aged six (6) months to fifty-nine (59) months in the programme and their mothers constituted the study sample. Both qualitative and quantitative methods were used to collect data and techniques including face-to-face interview, focus group discussion (FGD) and key informants interview (KII) were used. The study findings showed that, overall maternal nutrition knowledge among the study participants was relatively low (15.8%).Time spent before arrival to Out-Patient Care(OPC) site and also time spent at the Out-Patient site were found to be associated with unsuccessful treatment outcomes (P=0.02,P=0.002) respectively. Women who were far from health facility (> 4 km) were 85 % less likely to make 5 continuous visit without absenting (AOR= 0.15, 95 % CI 0.07, 0.29]). Shortage of "Plumpy nut" and sharing of the "plumpy nut" were found to be strongly positively associated with default treatment outcome (p<0.001).Compared to those who did not experience plumpy nuts shortages, those who experienced shortages were about 3.6 times likely not to recover successfully (95% CI, AOR=3.6, p<0.001).There was general improvement in the nutritional status of children benefiting from the programme which in part is indicative of effectiveness of the programme.The study however recommends that, Out-Patient sites be decentralized to all public health facilities in the district to reduce the travel time and supply of "plumpy nuts" to OPC should be regular.