Post-enrollment Risk Factors for Defaulting from Supplementary Feeding Programs in Chad, Kenya, and Sudan Pubblico
Palmer, Tess Anne (2017)
Abstract
Abstract
Post-enrollment Risk Factors for Defaulting from Supplementary
Feeding Programs in Chad, Kenya, and Sudan
By Tess Palmer
Background. Defaulting, defined as more than two consecutively
missed appointments at a Supplementary Feeding Program (SFP),
undermines recovery from Moderate Acute Malnutrition in SFPs.
Limited research has investigated factors associated with
defaulting based on patient baseline demographic information. Even
less research has explored unexpected events (ie. post-enrollment)
as predictors of defaulting in such programs.
Objective. This study identified factors associated with children
defaulting from SFPs based on responses to an exit interview
administered upon leaving the SFP in three settings: an
urban/semi-urban community in Chad, a rural/semi-nomadic community
in Kenya, and an internally displaced persons (IDP) camp in
Sudan.
Methods. Data were collected from questionnaires (N = 687 (Chad), N
= 275 (Kenya), N = 808
(Sudan)) administered to caregivers of children with moderate acute
malnutrition (MAM) ages 6-59 months upon their exit from an SFP.
The questionnaire collected information on the family's experience
in the program, perceptions of the program, as well as unexpected
events that occurred during their time enrolled in the program.
Country-specific multivariate logistic regression models identified
factors associated with SFP defaulting.
Results. Program defaulting was common (48.5% (Chad), 25.6%
(Kenya), 42.9% (Sudan)). In
multivariable, country-specific analyses, factors (p<0.05)
associated with defaulting included: reporting that the staff of
the SFP were giving out the incorrect ration (Chad), the patient's
dislike for the food at the SFP (Chad), reporting that the SFP was
too far away (Kenya, Sudan), describing the past year as busier
than expected (Kenya), families who described the last year as less
busy than expected (Kenya), participating in nomadic travel
(Kenya), reports of being too busy (Sudan), and having no one to
care for the other children at home (Sudan). Factors associated
with not defaulting were experiencing illness of the child while in
the program (Chad), reporting that the SFP was too far away (Chad),
caretakers being happy about the way they were treated at the SFP
(Kenya), reporting that the last three months were less busy than
other times (Kenya), feeling that their child seemed to be
recovering (Chad, Kenya, Sudan), experiencing that there was no
food at the SFP (Kenya), and reporting that the child had no one to
accompany them to the SFP (Sudan).
Conclusions. Significant risk factors for defaulting from SFPs
should be taken into account in planning programs as well as
redesigning programs to target potentially high-risk beneficiaries
in order to avoid high rates of defaulting.
Keywords: Supplemental Feeding Programs (SFP); Moderate Acute Malnutrition (MAM); Defaulting; sub-Saharan Africa
Table of Contents
Thesis:
Introduction ........................... 1-2
Methods ........................... 2-5
Results ........................... 5-6
Discussion ........................... 6-9
Limitations ........................... 9-10
Conclusion ........................... 10
Appendices:
Table 1 ........................... 1-2
Table 2 ........................... 3-6
Table 3 ........................... 7-8
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