Including children living with disabilities for future severe malnutrition guidelines: suggested areas for inclusion
| Suggested areas for inclusion | Included in 2013 WHO SAM guideline update | Included in x number of guidelines analysed for this study |
| Link of disability with malnutrition | Briefly | Briefly acknowledge link: 6/60 (10%) Acknowledge disability as a possible reason for malnutrition treatment failure or non-response: 39/60 (65%) |
| Proactive screening for disability and developmental delay | No | Proactively screen: 3/60 (5%) Disability yes/no on physical assessment form: 42/60 (70%) |
| Multidisciplinary team management (as available speech and language therapy, dieticians, physiotherapists, occupational therapy, psychologists, nurses, medical team including neurology and gastroenterology, social services) | No | Outlining multidisciplinary approach: 1/60 (1.5%
26
)
Suggesting disability as a reason for inpatient treatment: 18/60 (30%) |
| Disability-specific feeding advice, medical advice (as context-appropriate, possibly including advanced feeding techniques, eg, percutaneous gastrostomy) | No |
Specific feeding advice:
2/60 (3% 26 29 ) Noting disability (eg, cleft lip/palate) as possible indication for nasogastric tube feeding: 43/60 (72%) |
| Continued support within the home (eg, home visits, home adaptations) | No | 1/60 (1.5%28) |
| Referral mechanisms | No | 18/30 (30%)—mostly unspecific (‘referral to specialists’) |
| Counselling and advice for caregivers (including management of expectations) | No | 4/60 (7%) |
| Monitoring and evaluation | No | 3/60 (5%) |
| Consideration of children living with disabilities in nutrition emergencies, malnutrition prevention strategies | No | 1/60 (1.5% 29 ) |
| Linking to local and context-specific organisations/groups providing additional support | No | 3/60 (5%): ‘refer to appropriate support services’ (few specifics) |
| Linking to other relevant guidance | No | 1/60 (1.5% 26 linking to a cerebral palsy feeding and nutrition review42) |
SAM, severe acute malnutrition.