Improving the outcome of severe acute malnutrition by community-based management

Abstract

Background: Undernutrition is the leading underlying cause of death among under-five children in Nigeria. The few functioning inpatient health facilities are unable to carry the heavy prevalence burden. The community management of acute malnutrition (CMAM) targets children aged 6–59 months with severe acute malnutrition (SAM), providing maximum access, coverage, and appropriate clinical and nutritional care before life-threatening complications set in. Aim: The aim of this study is to evaluate the outcome of the outpatient therapeutic program (OTP) component of CMAM using the SPHERE indicators,a rural Nigerian community. Settings and Design: Jigawa state is located in the Sahel region of Northwestern Nigeria. It is a prospective cross-sectional study. Statistics: Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 17.5 statistical software. Descriptive statistics was used. Materials and Methods: Prospective data were collected from 16 United Nations Children's Fund (UNICEF)-assisted CMAM OTP sites in three local governments areas between its inceptions in July 2010 and end in August 2011 in a rural Nigerian state. The estimated number of children with SAM in communities and the actual number of children with SAM enrolled into the CMAM program was used to calculate the point treatment coverage in the CMAM program was used to calculate the point treatment coverage. Results: were represented in tables and graphs. Analyzed data were compared with the minimum SPHERE indicators as cutoff points for outcome performance. Result: A total of 24,419 children were admitted to the program accounting for 12% of the SAM target population with 12,073 children seen in in the three LGA that are assisted by UNICEF. Of 7,742 (64%) children who exited the program, 58% were cured and 40% defaulted, and all these children fell below the accepted minimum SPHERE standards. Death occurred in 2% and none were discharged non-recovered. Only 27% of the government-owned health facilities in these the selected local government areas were utilized to provide CMAM services. Conclusion: The performance of the CMAM program in Nigeria is 58% cure rate, 40% defaulter rate and 2% death rate standards. Large number of children with SAM were cured and prevented from dying.