Table 5

Synthesis of findings obtained from the use of the adapted WHO six building blocks
Theme Key findings
Facilitating factors Challenging factors
Nutrition governance -Nutrition is a priority for the government -Nutrition coordination not fully under government leadership
-Child nutrition policy developed
-CMAM is part of the nutrition strategic interventions in the country -CMAM training not yet included in the curriculum of medical schools
-Inpatient and outpatient CMAM guidelines developed and disseminated
Nutrition Financing -Primary health care service free of charge for under- 5 children -Most of CMAM funds provided by donors, and for short term interventions
-Funds dedicated to nutrition and CMAM available
Health and Nutrition Service Delivery -Primary health care activities delivered in the health facilities, including growth monitoring and promotion programme -Screening and management of acute malnutrition not delivered in the health centres, and not included into outreach health activities
-Outreach health activities performed by community clinics health workers
Human resources -Available staff adequate in numbers to cover the caseload of inpatient management of SAM children with complications -Health workers not trained for adequate identification and management of acute malnutrition
-Insufficient number of health facility staff to handle outpatient SAM and MAM caseloads
-Health workers not willing to work in rural areas
Equipment and supply -Presence of consultation rooms in the inpatient and outpatient health centres -Absence of dedicated spaces for children in the hospitals
-Presence of medical material in good working condition -Absence or inadequate latrines and water sources
-Available kitchen facilities in the inpatient health centres -Lack of anthropometric materials
-Absence of play areas and toys for children
-Kitchen facilities not well equipped
-Inadequate storage facilities
-Absence of paediatric wards
-Insufficient supply of medicines
-Absence of therapeutic and supplementary foods
Referral, monitoring and supervision mechanism -Existence of a functional reporting mechanism -Absence of a formal referral mechanism
-Existence of a regular supervision -Nutrition indicators not included in the health information system

Kouam et al.

Kouam et al. Nutrition Journal 2014 13:22   doi:10.1186/1475-2891-13-22

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