Abstract:

Community-based Management of Acute Malnutrition (CMAM) is a vital public health intervention for treating severe acute malnutrition (SAM). One of the critical components of CMAM is caregiver education, primarily delivered by health workers. However, resource limitations, including health worker shortages, often hinder the effectiveness of traditional methods. This study investigates the impact of audio messages on caregivers’ knowledge of key CMAM messages as a viable alternative to health workers’ face-to-face education. This experimental study was conducted in Adamawa State, Nigeria, using an intervention and control group. Eighty caregivers from two local government areas (LGAs), Girei and Yola South, were recruited. The experimental group received weekly audio messages containing CMAM key messages, while the control group received routine health talks delivered by health workers. Caregivers’ knowledge was assessed at the beginning and end of the intervention through structured interviews. Quantitative data were collected using the mHealth platform and analysed with SPSS software using descriptive statistics and t-tests. The paired samples t-test results showed that the caregivers who received the audio messages exhibited better knowledge of CMAM key messages compared to the control group (p< 0.05) at a 95% Confidence Interval. We have enough evidence to conclude that there is a statistically significant difference between the post-intervention scores of the control and experimental groups, with the experimental group showing higher scores. Audio messages have the potential to enhance the knowledge of caregivers on CMAM key messages, reducing the workload of health workers and ensuring that standardized messages are consistently delivered.

References:

[1].   2022, Global Nutrition Report, https://globalnutritionreport.org/resources/nutrition-profiles/africa/western-africa/nigeria/

[2].   Federal Ministry of Health and Social Welfare of Nigeria (FMoHSW), National Population Commission (NPC) [Nigeria], and ICF. 2024. Nigeria Demographic and Health Survey 2023–24: Key Indicators Report. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.

[3].   Black R. E., Allen L. H., Bhutta Z. A., Caulfield L. E., Onis M. D., Ezzati M.Mathers C., and Rivera J., 2008, Maternal and child under nutrition: global and regional exposures and health consequences. Lancet 371, 243–260

[4].   Collins, S., Sadler, K., Dent, N., Khara, T., Guerrero, S., Myatt, M., et al., 2006, Key issues in the success of community-based management of severe malnutrition. Food Nutr Bull;27(3 Suppl): S49-82.

[5].   Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., de Onis, M., Ezzati, M., et al., 2008, Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008; 371:243-60.

[6].   Global Nutrition Report GNR https://globalnutritionreport.org/reports/global-nutrition-report-2018/

[7].   Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., Onis, M. D., Ezzati, M., Mathers, C., and Rivera, J., 2008, Maternal and child under nutrition: global and regional exposures and health consequences. Lancet 371, 243–260

[8].   Collins, Steve and Sadler, Kate, 2002, “Outpatient Care for Severely Malnourished Children in Emergency Relief Programmes: A Retrospective Cohort Study.” The Lancet. Volume 360, Issue 9348, pp. 1824-1830.

[9].   Collins, S., 2004, “Community-Based Therapeutic Care: A New Paradigm for Selective Feeding in Nutritional Crisis.”

[10].  WHO, World Food Programme, U.N. System Standing Committee on Nutrition, and UNICEF. 2007, Community-Based Management of Severe Acute Malnutrition: A Joint Statement by the WHO, World Food Programme, U.N. System Standing Committee on Nutrition and UNICEF. http://apps.who.int/iris/bitstream/10665/44295/1/9789280641479_eng.pdf?ua=1&ua=1

[11].  Hagopian, G. A., 1996, The effects of informational audiotapes on knowledge and self-care behaviors of patients undergoing radiation therapy. Arch Fam Med 1996; 23:697–700.

[12].  North, N., Cornbleet, M. A., Knowles, G., Leonard, R. C. F., 1992, Information giving in oncology: a preliminary study of tape-recorder use. Br J Clin Psychol 1992; 31:2279–85

[13].  McHugh, P., Lewis, S., Ford, S., Newlands, E., Rustin, G., Coombes, C., Smith, D., O’Reilly, S., Fallowfield, L., 1995, The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomized, controlled trial. Br J Cancer 1995; 71:388–92.

[14].  Hack, T. F., Pickles, T., Bultz, B. D., Ruether, J. D., Weir, L. M., Degner, L. F., Mackey, J. R., 2003, Impact of providing audiotapes of primary adjuvant treatment consultations to women with breast cancer: a multisite, randomized, controlled trail. J Clin Oncol 2003; 21:4138–44.

[15].  Tattersall, M. H. N., Butow, P. N., Griffin, A., Dunn, S. M., 1994, The take-home message: patients prefer consultation audiotapes to summary letters. J Clin Oncol 1994; 12:1305–11.

[16].  Man-Son-Hing, M., Laupacis, A., O’Connor, A. M., Biggs, J., Drake, E., Yetisir, E., Hart, R. G., 1999, A patient decision aid regarding antithromobotic therapy for stroke prevention in atrial fibrillation: a randomized controlled trial. JAMA 1999; 282:737–43.

[17].  Jenkinson, D., Davison, J., Jones, S., Hawtin, P., 1988, Comparison of effects of a self-management booklet and audiocassette for patients with asthma. Br Med J 1988; 297:267–70.

[18].  Tattersall, M. H. N., Butow, P. N., Griffin, A., Dunn, S. M., 1994, The take-home message: patients prefer consultation audiotapes to summary letters. J Clin Oncol 1994; 12:1305–11.

[19].  Jenkinson, D., Davison, J., Jones, S., Hawtin, P., 1988, Comparison of effects of a self-management booklet and audiocassette for patients with asthma. Br Med J 1988; 297:267–70.

[20].  Hogbin, B., Fallowfield, L., 1989, Getting it taped: the ‘bad news’ consultation with cancer patients. Br J Hosp Med 1989; 41:330–3

[21].  Reynolds, P. M., Sanson-Fisher, R. W., Poole, A. D., Harker, J., Byrne, M. J., Cancer and communication: information-giving in an oncology clinic. Br Med J 1981; 282:1449–51.

[22].  Dunn, S. M., Butow, P. N., Tattersall, M. H. N., Jones, Q. J., Sheldon, J. S., Taylor, J. J., Sumich, M. D., 1993, General information tapes inhibit recall of the cancer consultation. J Clin Oncol ;11:2279–85.