Quality of care in nutritional rehabilitation in HIV-endemic Malawi

Caregiver perspectives

Datos Bibliográficos

ID15537330
AutoresPamela Fergusson (Liverpool School of Tropical Medicine, autor de correspondencia), Kingsley Chikaphupha (0000-0002-3534-3172, Research for Equity And Community Health Trust), Grace Bongololo (Research for Equity And Community Health Trust), Ireen Makwiza (Research for Equity And Community Health Trust), Lot Nyirenda (0000-0003-1398-5454, Research for Equity And Community Health Trust), Jobiba Chinkhumba (0000-0002-1921-619X), Anisa Aslam (University of Chester), Sally Theobald (0000-0002-9053-211X, Liverpool School of Tropical Medicine)
Año2009
Volumen6
Número1
Páginas89-100
Fecha de publicación2009-05-06
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaMaternal and Child Nutrition (JOURNAL)
Identificadores de la revistaISSN: 1740-8695 • E-ISSN: 1740-8709
EditorialWiley (PUBLISHER • GB)
DOI10.1111/j.1740-8709.2009.00191.x
PMID20055932
OpenAlexW2034285473
IdiomaEN
Citas recibidas2
Referencias citadas30

In Malawi, HIV and malnutrition are two of the most common causes of childhood morbidity and mortality. This qualitative study based in Nutrition Rehabilitation Units (NRU) in HIV-endemic Malawi explores caregiver's (staff and family) perspectives on quality of care for severely malnourished children. Three carer focus groups and 30 carer and staff in-depth interviews were conducted in two NRUs. The interviews and data analysis used a grounded theory approach, using both male and female Malawian researchers. Trustworthiness was enhanced through the researchers' prolonged engagement with the study setting and participants. The use of multiple methods - interviews, focus groups and observation - allowed for triangulation of the data. Data was then cross-referenced between staff and family caregiver reports. The analysis generated five themes. 'We have different blood' referring to staff attitudes and underperformance, 'What wrong did I do to God?' referring to stigma and chronic illness, 'My other children back home' referring to the carer's multiple responsibilities and challenges, 'Always in short supply' referring to resources available in the NRU (milk, medicine, space, hygiene) and 'you are always lagging behind' referring to the need for change and participants recommendations. Quality of care is a complex issue, bound by resources and capacity, influenced by stigma and hierarchy and limited by caregivers' conflicting responsibilities. Valuing and involving caregivers is essential in improving quality of care. Care should be patient and family centred and HIV services should be integrated into malnutrition care at the hospital and community level

Family medicine · Focus group · Grounded theory · Malnutrition · Physical therapy · Psychiatry · Qualitative research · Stigma (botany · Child Nutrition and Water Access · Food Security and Health in Diverse Populations · Medicine · Nursing · Poverty, Education, and Child Welfare · Rehabilitation