missed opportunities in its early diagnosis and management.
Preventing PEM from progressing to severe acute
malnutrition (SAM) in or after acute childhood illnesses is
a great challenge to the health systems, yet few studies
are available to establish the magnitude of the problem.
METHODOLOGY
It was a descriptive cross sectional study in which health workers in
the five Health Centre IVs (HCIV’s) in Wakiso district were
interviewed to determine their knowledge on PEM. It also observed
them as they managed children with acute childhood illnesses, in
particular assessing the ability of the health workers to indentify
PEM, treat and advise care takers on its prevention.
The study participants included all the clinical officers and nurses
involved in treatment of children under five years at outpatient
clinics, pediatric wards and nutrition clinics. At each health facility, 9
health workers looked after under five children during the time of
the study making a sample size of 44 respondents. The questionnaire
was administered by a research assistant, while observations
were carried out by the investigators.
The study tools included a questionnaire administered that
collected demographic characteristics and knowledge of health
workers attending to children below five years. A check list was
filled in as the health workers were being observed as they
managed the children and a child assessment form on which
nutritional parameters measured were recorded by the
investigators.
The questionnaire was pre-tested among a few health workers in
Mulago hospital Uganda and the adjustments made. Informed and
written consent was obtained from the health workers and the
children care takers. The Institutional Review Board (IRB) approval
was obtained from Makerere University College of Health Sciences.
Data analysis
Data was entered into EPI Data version 3.1 and then exported to
Statistical Package for Social Sciences (SPSS) version 16 for
analysis. Continuous variables were summarized using means and
standard deviations, while categorical variables were summarized
using frequencies. Wakiso district is located in Central Uganda,
coordinates 00°24’N 32°29’E.
RESULTS
Knowledge of health workers
Of the respondents interviewed, 32 (72.7%) had ever
received continuing medical education (CME) or training
in PEM and agreed that PEM was a common condition
among children.
Respondents’ knowledge in the management of PEM
All the respondents could not categorize the management
of PEM into stabilization and rehabilitation phases,
but they could explain how to manage PEM.
Health workers practice
Twenty two percent of the children were assessed in