Jointly conducted by IRD and INSERM, this research evaluates the acceptability of outpatient nutritional recovery in Senegal.
Marie Varloteaux, researcher at TransVIHMI (Institut de Recherche pour le Développement).
Thesis defended in 2017 at the doctoral school École doctorale Sciences Chimiques et Biologiques pour la Santé (Montpellier ; 1992-....).
This research is the result of an international co-supervision between several partner institutions.
Referenced in the ABES/STAR network, this thesis meets the rigorous criteria of French higher education.
Malnutrition is a scourge that disproportionately affects children and adolescents living with HIV in Africa, and Senegal is not exempt from this alarming reality. Indeed, according to data from the World Health Organization (WHO), children living with HIV are more likely to suffer from malnutrition due to their precarious health status and the side effects of antiretroviral treatments. Despite efforts made since 1998 to improve access to antiretroviral treatments, pediatric care remains lagging behind that of adults, raising crucial questions about the effectiveness of nutritional interventions and their acceptability by families.
The Snac's study, which was set up to evaluate the effectiveness and acceptability of outpatient nutritional recovery, revealed interesting and sometimes surprising results. Involving 112 children and 30 healthcare professionals across 12 care sites, researchers were able to identify barriers to adherence to these programs. For example, 68% of parents and 58% of children understood the information provided, but gaps remain, particularly regarding the right to withdraw from the study, raising questions about the transparency of the information communicated.
The results show that, although the acceptability of the intervention is generally positive, challenges remain. Disgust for Ready-to-Use Foods (RUF) and long waits before consultation are barriers to adherence. These elements highlight the need for more effective communication and increased support from health authorities to ensure the sustainability of these interventions. Furthermore, it is important to note that the perception of RUF varies from culture to culture, and it would be wise to consider local alternatives that may better suit the tastes and eating habits of families.
It is essential to ask how to improve the acceptability and effectiveness of these programs. Decision-makers must take into account feedback from families and healthcare professionals to adapt interventions. For example, awareness workshops could be organized to better inform parents about the benefits of RUF, while including testimonials from other families who have benefited from these programs. Collaboration among various stakeholders in the health sector is crucial to overcoming these obstacles and ensuring a regular supply of RUF.
Moreover, it would be relevant to explore partnerships with non-governmental organizations and local businesses to diversify supply sources and ensure the quality of RUF. By integrating feedback from families and healthcare professionals, it will be possible to co-construct solutions that meet the specific needs of children living with HIV.
In summary, this research highlights the importance of an integrated and participatory approach to combat malnutrition among children living with HIV in Senegal. The results of the Snac's study should serve as a basis for developing more effective public policies tailored to the needs of vulnerable populations. It is crucial that decision-makers take these results into account to implement strategies that not only improve access to care but also enhance awareness and education for families on nutrition.
Finally, it is imperative to extend this research to other West African countries, where similar contexts exist. By sharing best practices and learning from the experiences of other countries, it will be possible to create a support network that will promote the fight against malnutrition among children living with HIV throughout the region. Thus, the collective commitment of all stakeholders will be key to transforming these challenges into opportunities and ensuring a better future for vulnerable children.
Key Facts
- 68 % : of parents understood the information provided on nutritional recovery.
- 58 % : of children answered the questions correctly about the information system.
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Sources and Access
Marie Varloteaux. Acceptabilité de la récupération nutritionnelle ambulatoire chez les enfants de sept ans et plus infectés par le VIH suivis dans douze sites de prise en charge au Sénégal. Médecine humaine et pathologie. Université Montpellier, 2017. Français. ⟨NNT : 2017MONTT163⟩. ⟨tel-01748058⟩