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Improving defaulter rates in Ambulatory Feeding Programs. Ellen van der Velden (Investigator) Saskia van der Kam. June 2008. Background High defaulter rates in ATFP. Objectives.

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improving defaulter rates in ambulatory feeding programs

Improving defaulter rates in Ambulatory Feeding Programs

Ellen van der Velden (Investigator)

Saskia van der Kam

June 2008

objectives
Objectives
  • Identify key factors modifiable by MSF that would decrease defaulting in ambulatory feeding programs (ATFP)
methods
Methods
  • Analysis of available quantitative program data
  • Analysis of qualitative information from interviews and observation

(all under program field conditions)

methods1
Methods

Plus

  • Some defaulter interviews in South Sudan
results quantitative methods
Results Quantitative methods
  • Defaulters do not differ from non-defaulters in terms of
      • Age
      • Gender
      • Weight on admission
      • Height on admission
  • Irregular attendance not associated with defaulting
  • Defaulting occurred regardless of last recorded W/H status
qualitative methods
Qualitative methods

Behaviour analysed from three perspectives

  • Personal perception of likely consequences (Behaviour belief)
  • Social norms (Normative belief)
  • Personal perception of ability to act (Control belief)
result personal and social beliefs
Result Personal and Social Beliefs
  • Caretakers perceived their child was sick, not malnourished
  • Caretakers lacked an understanding of the purpose of the nutritional program
  • Social beliefs/norms have a limited impact on defaulting rates
results control beliefs
Results Control Beliefs

Security

  • Insecurity related to traveling was identified as a barrier
  • Influence of insecurity not measurable

Costs

  • Direct costs (money) seen as low
  • Indirect costs are considerable

(e.g. long waiting time, travel time, opportunity costs)

limitations of study
Limitations of study
  • Conducted under field conditions while providing technical support to programs
  • Limited access to beneficiary perspectives
conclusion
Conclusion

Many obstacles identified are modifiable

  • Mother’s understanding of program aims
  • Geographical access
  • Patient waiting times and clinic opening
  • Food stock ruptures
recommendations
Recommendations
  • Improve MSF- caretaker communication (personal and community level)
  • Outreach indispensable for retention and tracing
  • Decentralization to increase access
  • Efficient patient flow
acknowledgements
Acknowledgements
  • Field teams and beneficiary participants

in the 5 programs

  • Royal Tropical Institute (KIT),

Amsterdam