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Quality of care in nutritional rehabilitation in HIV-endemic Malawi: caregiver perspectives

Fergusson, Pamela, Chikaphupha, K., Bongololo, G., Makwiza, I., Nyirenda, L., Chinkhumba, J., Aslam, A. and Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X (2010) 'Quality of care in nutritional rehabilitation in HIV-endemic Malawi: caregiver perspectives'. Maternal & Child Nutrition, Vol 6, Issue 1, pp. 89-100.

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Abstract

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.

Item Type: Article
Uncontrolled Keywords: Caregivers; Malawi; HIV
Subjects: WA Public Health > WA 100 General works
WA Public Health > WA 20.5 Research (General)
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 105 Deficiency diseases
Faculty: Department: Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI): https://doi.org/10.1111/j.1740-8709.2009.00191
Depositing User: q Moody
Date Deposited: 05 Aug 2010 13:09
Last Modified: 06 Feb 2018 13:00
URI: http://archive.lstmed.ac.uk/id/eprint/1072

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