Factors associated with adherence to ready to use Therapeutic foods among children aged 6-59 months receiving outpatient therapeutic care from selected Kampala health facilities.

Abstract

Background: Malnutrition contributes to more than one-third of all child deaths globally. While Ready-to-use Therapeutic Food (RUTF) has transformed the treatment of uncomplicated forms of severe malnutrition, adherence is a challenge. The study aimed at assessing the magnitude and factors associated with adherence to RUTF among children aged 6-59 months at selected health facilities in Kampala. Methods: A descriptive cross-sectional analysis of data described the prevalence of adherence to RUTF and associated factors among malnourished children aged 6 to 59 months. This involved administration of a structured questionnaire for caretakers of the children. Adherence to RUTF was measured using the proportion of consumed sachets out of the total sachets given during the previous visit. Qualitative data on facilitators and barriers to adherence were collected using key informant interviews and focus group discussions. Quantitative data were analyzed using stata Version 17.0. Descriptive statistics and categorical variables were summarized as frequencies and percentages, whereas the continuous variables were summarized as median with interquartile range (IQR) and mean with standard deviation, while thematic analysis was done for the qualitative data. Results: The study results revealed a high prevalence (69.6%) of adherence to RUTF. The major contributing factors that were associated with good adherence to RUTF were: counseling patients on the benefits of RUTF, including on the treatment plans as well as the caretaker having a good perception of the benefits of RUTF. The barriers to adherence were: RUTF stock out, transport costs to the health facility, incompatibility of the drug to some patients, hardship in following up with patients, and selling and sharing of RUTF. The others were; real caretakers not being trained, caretakers being brain washed by propaganda about the drug, fear of stigma and fear of the child being admitted, the health workers not being enough to handle the patients, administration of the RUTF by the health workers to non-severely malnourished children.