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Table 1 Summarising guidelines in Bangladesh and Kenya

From: Strengthening the role of community health workers in supporting the recovery of ill, undernourished children post hospital discharge: qualitative insights from key stakeholders in Bangladesh and Kenya

  Inpatient and CMAM Bangladesh IMAM Kenya CHW strategy Bangladesh CHW strategy Kenya
Admission Management of Complicated severe acute malnutrition is inpatient Acknowledges role of CHWs in malnutrition, and in referral to hospital No acknowledgment of role of CHW
Acknowledges poor linkage between community and hospital levels
Discharge criteria Upon resolution of complication and to be managed according to CMAM guidelines N/A
Linkage to support at discharge Transfer slip with description of monitoring plan for specific patient CHW should discuss inpatient child’s requirements with health worker to understand post-discharge health needs No specific reference to referral back to CHWs from hospital
Post-discharge support On discharge children should be sent for follow-up to the nearest public or NGO health facility and followed-up regularly, also enrolled into CMAM, included in growth monitoring sessions at health centres, and enrolled into safety net programmes
According to CMAM: Management in the community health facilities with some patients followed-up at home in case of default or “other challenges”. CHWs can provide home-based care for children with SAM without referral in the absence of any complications.
CHW should discuss with the child’s carer the appropriate home environment to facilitate recovery; and ensure CHW is contactable if there are any concerns about the child’s recovery
“well trained and motivated” CHWs should work at the community-based health facility to monitor children on treatment and assist in the distribution of nutrition therapeutic products.
Follow-up of patients with chronic conditions eg TB.
Malnutrition not mentioned at all
Malnutrition not mentioned specifically at all in the guidelines