Knowledge, perspectives and practices of doctors and dietitians regarding the severe acute malnutrition protocol in South Africa
1
Division of Human Nutrition, Department of Global health, Faculty of Medicine and Health Sciences., Stellenbosch University, Cape Town, South Africa
2
School of Applied Health Sciences Centre of Excellence for Nutrition (CEN), North- West University, Potchefstroom Campus, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1761
ABSTRACT
INTRODUCTION:
Severe acute malnutrition (SAM) remains a major cause of childhood morbidity and mortality despite established management guidelines. In South Africa, resource constraints and competing health burdens challenge effective guideline implementation, and limited data exist on healthcare professionals’ knowledge, perceptions, and practices regarding in-hospital SAM management.
AIM:
To determine the knowledge, perceptions, and practices of doctors and dietitians regarding feeding protocols used during the in-hospital management of children with SAM in South Africa.
METHODS:
A descriptive cross-sectional study with an analytical component was conducted among doctors and dietitians involved in inpatient SAM management across South Africa. Data were collected using an online self-administered questionnaire comprising demographics, knowledge of SAM guidelines, perceptions, and current practices. Knowledge was assessed using 14 questions, with ≥80% classified as high knowledge, 50–79% as average, and <50% as poor.
RESULTS:
Forty-two participants (3 doctors and 39 dietitians) completed the survey. The mean knowledge score was 67%, with no significant difference between doctors (61%) and dietitians (67%). Most participants preferred the WHO SAM protocol (63%) over the South African guideline (16%), while 7% reported not following any protocol. Concerns regarding F-75–associated diarrhoea were common (64%), and 85% favoured lactose-free formulations. Despite perceived benefits of semi-elemental feeds, most respondents continued to use F-75 (86%) and F-100 (89%).
CONCLUSIONS:
Findings indicate suboptimal knowledge of SAM management among healthcare professionals and highlight the need for improved training and guideline revision. Ongoing education and research are essential to optimise SAM management and reduce childhood mortality.
Severe acute malnutrition (SAM) remains a major cause of childhood morbidity and mortality despite established management guidelines. In South Africa, resource constraints and competing health burdens challenge effective guideline implementation, and limited data exist on healthcare professionals’ knowledge, perceptions, and practices regarding in-hospital SAM management.
AIM:
To determine the knowledge, perceptions, and practices of doctors and dietitians regarding feeding protocols used during the in-hospital management of children with SAM in South Africa.
METHODS:
A descriptive cross-sectional study with an analytical component was conducted among doctors and dietitians involved in inpatient SAM management across South Africa. Data were collected using an online self-administered questionnaire comprising demographics, knowledge of SAM guidelines, perceptions, and current practices. Knowledge was assessed using 14 questions, with ≥80% classified as high knowledge, 50–79% as average, and <50% as poor.
RESULTS:
Forty-two participants (3 doctors and 39 dietitians) completed the survey. The mean knowledge score was 67%, with no significant difference between doctors (61%) and dietitians (67%). Most participants preferred the WHO SAM protocol (63%) over the South African guideline (16%), while 7% reported not following any protocol. Concerns regarding F-75–associated diarrhoea were common (64%), and 85% favoured lactose-free formulations. Despite perceived benefits of semi-elemental feeds, most respondents continued to use F-75 (86%) and F-100 (89%).
CONCLUSIONS:
Findings indicate suboptimal knowledge of SAM management among healthcare professionals and highlight the need for improved training and guideline revision. Ongoing education and research are essential to optimise SAM management and reduce childhood mortality.
| eISSN: | 2654-1459 |
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