Post-enrollment Risk Factors for Defaulting from Supplementary Feeding Programs in Chad, Kenya, and Sudan 公开

Palmer, Tess Anne (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/cz30pt56w?locale=zh
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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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