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Quality of follow up for small and nutritionally vulnerable <6M.

This question was posted the Management of small and nutritionally at risk infants under six months and their mothers (MAMI) forum area and has 5 replies.

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Maha Basodan

Normal user

2 Nov 2021, 14:09

Dear colleagues,

I am  looking to a model/ criteria to qualify the follow up service for Small and nutritinally vulnerable <6M infants as adequate or inadequate. Does anyone have an idea or can recommend any source that can help?

Thanks in advance

Alice Burrell

Save the Children

Technical expert

23 Nov 2021, 15:02

Dear Maha,

I am not completely clear what it is you are looking for - but if you wish to assess the quality of a follow-up monitoring visit for mother-infant pairs enrolled in to the MAMI Care Pathway, I'd suggest to create a supervision checklist. This does not yet exist that I am area of, but would likely include the critical aspects that a health worker should complete at a follow-up visits and could be completed as a spot-check by supervisors, for example:

- infant checked for IMCI danger signs

- infant's growth, feeding and maternal mental are monitored

- relevant counselling is provided e.g. tailored to specific challenges and actions agreed, in line with counselling SOP (there are existing checklists to check the quality of a 1-1 counselling e.g. good listening skills, empathy, non-judgemental, heads in line, no barriers, patient, small amount of info provided)

- Frequency of visits is assessed and next visit date is agreed

- If infant is 6 months of age, 6-month of age outcome review is completed with relevant referrals to continued services made

Hatty Barthorp

Global Nut' Advisor / GOAL

Normal user

24 Nov 2021, 09:40

Maha - Are you looking for markers/metrics to assess the quality of care after enrolment, or markers to assess the development of the infant recieving supportive care?

Maha Basodan

Normal user

17 Dec 2021, 18:16

Thank you Alice and Hatty for your inputs. You are right maybe I didn't make it clear what exactly that I am looking for. However you both responded in the same line. Actually I am looking for tools/model to qualify a single/individual follow up as adequate or not and also to qualify the collective follow up service provided by a site /location as adequate or not.

Qualifying an individual follow up would , as Alice mentioned, be done  by a check list. I understand that I can for example take the MAMI follow up form and make a check list out of it. Some of the items that will be included were mentioned by Alice.  Yet I posed the question to know if there is a check list already done for this purpose that I am not aware of.

Secondly, I am looking to some standards to collectively qualify a site providing Follow up service, for nutritionally vulnerable <6m, as proving adequate or inadequate service. I suppose such evaluation as adequate / inadequate  would involve the facility; equipment ; number of staff; privacy; percentage of infants weighed; percentage of women asked about depressive symptoms.....etc I understand that such standards will differ from one country to the other according to the service provided , but I am looking to anything that I can use as a guide.

I appreciate any insight on this. Thanks a lot

Alice Burrell

Save the Children

Technical expert

21 Dec 2021, 13:06

Hi Maha,

It may be useful to take a look at COMPASS Module, navigate to 'Nutrition' and you'll find the MAMI Module. https://compass.savethechildren.org.uk/

If you go to 'Auditing Activity' you'll find:

- MAMI Monitoring List

- Supervision Quality Benckmarks 

I hope these may be helpful for you to adapt for your needs.

Maha Basodan

Normal user

30 Dec 2021, 12:33

Thank you Alice , this is very useful

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