Program Management Research Articles

Navigating university-OPMs

This panel focuses on the second theme of the conference, that is TEL Pedagogies: What can we learn from examples of success and failure in designing with and implementing old and new pedagogies enabled by technology? It explores Online Program Management companies' (OPMs) role in higher education partnerships to design and deliver spaces for online learning. Utilizing key theoretical frameworks such as Resource-Based View (Barney,1991; Kero & Bogale, 2023; Prahalad & Hamel, 1990; Wernerfelt, 1984) and Holon IQ’s Higher Education Digital Capability Framework (2020), the panel empowers universities to identify strengths, gaps, and strategic opportunities for collaboration. Barney (1991) suggests that by posing inquiries related to value, rarity, imitability, and organisation (VRIO), insights regarding competitive advantages, sustainability, and capability gaps can emerge, facilitating strategic decision?making. In the context of OPMs and university clients, VRIO offers a framework to comprehend the competitive advantage and sustainability of educational partnerships. Through discussion and debate the panel aims to challenge sociocultural norms, address challenges in transitioning to online formats, and propose effective partnership strategies.

Meeting the accreditation standard through implementation of a multiprogram residency advisory committee and ongoing quality improvement

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To describe the process utilized by a large multiprogram residency site to expand preceptor engagement and establish ongoing quality improvement efforts in order to meet the program’s needs in response to evolving ASHP accreditation standards. Summary A multiprogram residency advisory committee (RAC) primarily composed of residency program leadership was formed to focus on aspects of program management and accreditation compliance that were not being addressed at the monthly all-preceptor meeting. The ASHP standard and a recent residency accreditation survey guided the RAC agenda, which led to the creation of a combined manual for the institution’s 5 residency programs and a preceptor manual. Preceptor engagement was improved through the establishment of local preceptor requirements, inclusion of preceptor representatives on the RAC, expansion of subcommittee opportunities, addition of a preceptor midpoint retreat, and optimization of the end-of-year preceptor retreat. Communication with residents and identification of continual improvement opportunities were improved through roundtables with residents, residency program directors, and the RAC chair; a monthly meeting with the rotating chief resident and RAC chair; and face-to-face exit interviews with the department’s chief of pharmacy. The RAC chair has been a key figure in coordinating program change to meet the ASHP standard as well as leading planning for subsequent ASHP surveys. Conclusion Through the establishment of a multiprogram RAC and a RAC chair, our program has been able to engage a large preceptor group that is dedicated to continual improvement and provides the ability to dynamically respond to ASHP’s progressing guidance for pharmacy residency programs.

A comparative study of home and host country effects on the academic performance of Chinese students in transnational education

ABSTRACT This study examines the impact of intercultural learning, from the perspective of home versus host country, on the academic performance of Chinese students in an Australian university’s transnational education program. It integrates transformative learning theory and cognitive load theory as the conceptual framework and compares the academic performance of students who remained in China with those who went to Australia to complete the same Australian university degree. Using a difference-in-differences approach, our analysis revealed a significant performance difference between the Australia-based and China-based groups by year level after controlling for academic ability. The findings have practical and policy implications for student support and transnational education program management in Australian universities. The study highlights the need for tailored support to help Chinese (and possibly other international) students during their first year of arrival in Australia. It also calls for embedding intercultural learning into discipline-specific programs.

Shaping the Quranic Generation from an Early Age (Study of Imtaq Programme Management in PAUD Akbar, Kaur Regency, Bengkulu)

This study discusses the management of the imtaq program at PAUD Akbar. The problems discussed in this study are planning, implementation, and assessment of the imtaq program at PAUD Akbar. This study uses descriptive qualitative research. Data collection techniques include interviews, observation, and documentation studies. Data analysis techniques using data reduction, data presentation, and conclusion drawing. The results of the research are: First, Akbar PAUD has formulated imtaq program planning. The imtaq program is a flagship program because it is in accordance with the need to obtain religious education in line with the vision and mission of PAUD Akbar. Program planning consists of daily, weekly, and annual programs. Secondly, the implementers of the imtaq program include the principal, teachers, parents, and the community who work together in implementing the program. Teachers apply four learning methods, namely, the play method, the storytelling method, the singing method, and the demonstration method. Third, teacher assessment is carried out in the form of assessments on aspects of child development and cognitive, affective, and psychomotor aspects. The assessment is carried out by teachers by conducting observations, children’s self-assessment, and portfolio assessment. The results of the follow-up of the program are still continued, but there are some improvements in improving facilities and infrastructure, teacher competence, and variations in learning models.

Do We Contribute to Women's Empowerment? Insights From a Nutrition-Sensitive Agriculture Project Implemented in Nong, Laos.

The gender-gap in power is still persistent around the globe. Nutrition-Sensitive Agriculture (NSA) interventions have been implemented to increase women's empowerment as a goal in itself, and as a pathway to food and nutrition security (FNS). However, contradicting evidence exists on whether the interventions, besides food security, realize women's empowerment. Furthermore, the concept of women's empowerment has different meanings across different cultures, regions, and countries. To assess the understanding of, and perspectives on, women's empowerment among different stakeholders in the context of an NSA project in Laos, and to assess whether this project contributes to women's empowerment and FNS. Semistructured interviews were conducted with local implementers of NSA interventions (n = 13) and senior program managers and advisors (n = 5). Six focus group discussions were conducted with community members (n = 46). Our findings reveal that community members had a materialistic understanding and local implementers an instrumental understanding, in contrast to senior program managers and advisors, who had an egalitarian understanding of women's empowerment. The level of women's empowerment in Nong was considered low by all respondents. Furthermore, respondents reported that the NSA interventions had a positive impact on FNS, but not on women's empowerment. In a community in which both women's empowerment and FNS are low, working with women may contribute to FNS, but not necessarily contribute to women's empowerment. Nevertheless, from an emic perspective, women do feel more empowered as the interventions contributed to increased household capacity to address FNS.

Strategic program management: Performance accountability driving use in national governments

AbstractStrategic program management (SPM) is an approach for advancing the aspirations of programs and their impact. While programs are omnipresent in government, concerns exist that they are not always strategically managed. Studies that examine SPM are lacking. This study defines and conceptualizes SPM, examines it in two national governments (Brazil and Indonesia), and focuses on felt performance accountability as a driver of SPM use. SPM use is highly uneven, and despite concerns about the effectiveness of performance accountability in the public sector, a key finding is that program managers' felt performance accountability is associated with increased SPM use by program officials. Managers' performance accountability also increases political appointees' support for programs and decreases their interference with program priorities. These findings are important because they provide a means for program officials, typically civil servants, to strengthen the strategic direction of public programs. Recommendations are made for strengthening the performance accountability of managers.

Bridging the "know-do" gap to improve active case finding for tuberculosis in India: A qualitative exploration into national tuberculosis elimination program staffs' perspectives.

In 2022, India's national tuberculosis (TB) elimination program (NTEP) commissioned a national level evaluation of active case finding (ACF) for TB to guide evidence-based strategic planning. As part of this evaluation, based on secondary data analysis we observed that the quality of ACF was suboptimal in 2021. Hence, this study aimed to understand the enablers, barriers, and suggested solutions to improve ACF for TB in India from NTEP staff (provider) perspective. This was a descriptive qualitative study involving key informant interviews from six districts and eight states, conducted between February and August 2023. We purposively selected key state- district- and sub-district-level program managers and implementers who were experienced and vocal. The interviews were audio recorded and transcribed verbatim by research interns and investigators. Two investigators independently did manual descriptive thematic analysis, and a third investigator resolved inconsistencies. The themes and categories emerged by collating together the results of the coding process. A total of 34 key informant interviews were conducted and of these, four were repeat interviews. Adequate budgets for ACF including incentives, performance review mechanism, engagement of all stakeholders, adopting a community friendly approach, use of rapid diagnostic tests and digitalization were the perceived enablers. In some states ACF was implemented in general population (not restricted to high-risk population) following directives at state level. There were limited mechanisms to ensure ACF quality indicators were met before disbursing incentives and cross-verification of the aggregate ACF care cascade numbers that were reported in Ni-kshay (electronic TB information management system under NTEP). In addition to the state and district level implementers having limited understanding of concepts around ACF (quality indicators, number needed to screen and yield), we also inferred the presence of a 'know-do' gap for many activities under ACF. The suggested solutions were around capacity building and quality improvement strategies. The existing national ACF guidance should be revised to emphasize capacity building, need to carry out ACF in high-risk (not general) population, quality control-linked incentives, and regular implementation monitoring of the activities. This should contribute towards better coverage and improved quality translating into better ACF outcomes.

Development method in a large-scale public sector IT programme

The Norwegian parental benefit programme started as a large-scale information technology operation to automate and provide self-service solutions for parental benefit applications. This benefit replaces lost salaries for about 100,000 parents every year while parents are home with new-born children. A previous programme to modernize IT solutions was stopped. The new programme replacing legacy solutions from the 1970s was seen as a large, complicated, and risky undertaking with a cost limit of USD 130 million. Initially, this programme had three main releases based on an internal development method combining project management and agile methods. During the second release, the programme experienced challenges with coordinating work across the business and development projects. The programme manager established a task force to propose changes in the development method for the last release. We then ask the question: If you were part of this task force, what should the programme manager do to remedy the coordination challenges for the last release? This teaching case is based on a longitudinal case study and is relevant for graduate or continuing education courses in information systems development or IT project management during which students learn how to organize efficient software development at scale.

Impact of School-Based Feeding Program on Pupils Reading Performance in San Gabriel Elementary School

This study examines the impact of a school feeding program on the reading skills of Grade IV pupils. The research hypothesizes that a well-structured and effectively implemented feeding program can enhance pupils' reading performance. Specifically, the study aims to determine how the school feeding program influences the reading performance of Grade IV pupils at San Gabriel Elementary School during the 2022-2023 school year. The study sougth to address several key questions: What is the socio-demographic profile of the pupils (age, sex, parents’ education, family income, and BMI)? What is the impact level of the school feeding program in terms of physical facilities, fund management, paraphernalia, and food preparation? What is the reading performance of the pupils? Is there a significant relationship between the pupils’ socio-demographic profile and the effectiveness of the school feeding program? Lastly, is there a significant relationship between the feeding program’s impact and reading performance? The research employs a descriptive-correlational design and involves 32 Grade IV pupils from San Gabriel Elementary School, selected through purposive sampling. Data collection instruments included a modified pupil profile survey and a school feeding program assessment, with responses measured using a 5-point Likert scale. The data were analyzed using frequency, percentage, mean, standard deviation, Biserial Correlation, and Pearson r. Findings reveal that the pupils, all aged 9, consist of an equal number of boys and girls. Most parents had completed high school, and family incomes were typically below 9,000 pesos. Pupils generally had a normal BMI. The school feeding program was found to have an outstanding impact on both nutritional support and reading performance, with a significant correlation between program management and pupils' reading improvement. A significant relationship was also found between the socio-demographic profile and program effectiveness.

The Management of Sports-Oriented Physical Education Program in China

This quantitative research determines perceptions students on the sports-oriented physical education program in a selected university in China in terms of Seasons, Team Affiliation, Formal Competition, Record Keeping, Culminating Events, and Festivity. Mean scores of each construct were used to determine satisfaction levels overall and assess differences by demographic factors, including sex and year level, through a quantitative analysis approach. Students overall rated the program highly, expressing that it is generally well-run across all dimensions. Festivity received the highest scores, highlighting students' appreciation for community development and the celebratory aspects of the program. No statistically significant differences were found by sex or year level, suggesting the program is perceived as accessible and fair for all students. Some areas for improvement were identified, such as competition fairness and record-keeping practices. Recommended adjustments include increased transparency in competition guidelines, comprehensive record-keeping practices, and introducing flexible team roles to better meet student expectations for engagement, skill development, and satisfaction within the PE program. These findings suggest that the physical education program is organized effectively to accommodate diverse student abilities, fostering an inclusive environment.

The Role of Program and Project Management in Increasing the Competitiveness of Russian Universities: A Comparative Analysis Including China and India

The Role of Program and Project Management in Increasing the Competitiveness of Russian Universities: A Comparative Analysis Including China and India

Determinants Influencing Utilization of Antenatal Care Services in Tabora Region, Tabora Municipality, Tanzania

This study examines the determinants influencing the utilization of antenatal care services (ANC) in in Tabora region with a particular focus on Tabora Municipality, Tanzania. The study used both quantitative and qualitative methods to analyze the problem. The study uses primary and secondary data obtained from the field. Tools used for data collection were questionnaires, interviews, and observation. This study employed a cross-sectional research design. This design was preferred because the design allowed the collection of data from different groups of respondents at one point at a time. Similarly, the design had a greater degree of accuracy and precision in the data collected and used for statistical description and interpretation. The study found that there was low utilization of antenatal care services in Tabora Municipality. The study revealed that the low utilization of ANC in Tabora Municipality can be solved by addressing the determinants that are responsible for the low use of ANC services. The study identified a number of determinants that influence ANC visits such as spousal involvement in antenatal clinics, the attitudes of health service professionals, clinic opening days for the antenatal care services by client satisfaction and integrated approach to antenatal care services. The determinants that affect the use of ANC visits are not only many and complex, but they play different roles in different situations. The study revealed that men and the whole community should be included in the ANC campaign so that they understand more about potential risks for pregnant women. This would increase the level of ANC use and thus reduce the high incidence of maternal and neonatal death in Tanzania including the Tabora region that results from poor utilization of ANC services. Also, this study adds knowledge to health service providers in understanding the determinants that limit pregnant women’s utilization of antenatal services finding ways to improve the services and encourage women to utilize ANC services. The study findings will enable programme planners, policymakers, implementers and managers to come up with strategies for interventions that will enable pregnant women to start seeking and utilizing ANC services early in pregnancy and to have fewer pregnancy complications that lead to maternal and neonatal deaths

Re-engineering Agricultural Innovation in Southeast Asia (RAISE-Asia)

Feeding the growing global population and reducing poverty require innovative approaches in agriculture and food systems to sustain the planet’s health and food requirements. Sustainable development can be achieved by generating new knowledge and translating them into use through innovation process. A customer-oriented technology readiness level (COTRL) tool is presented to re-engineer agricultural innovation by systematically assessing new agricultural technologies with customer input and ensuring that the early design of the scientific research already has the end-products in mind. The COTRL methodology will integrate research, prototyping, and commercialization efforts and facilitate a disciplined and impactful innovation process. It will guide researchers and scientists, research managers and coordinators, funding agency program managers, policymakers, and other personnel involved in bringing scientific discoveries to market for societal impact. The COTRL framework can be used to strengthen the collaboration among academia, research institutions, networks of excellence, and the private sector in the ASEAN to create an effective ecosystem for manpower and structural capability development, knowledge sharing, and business development within and across member states.

The Adaptation of Executive Education Programs in Thailand during the COVID-19 Pandemic

This study explores the factors influencing the management of an executive education (EE) program in Thailand during COVID-19. The pandemic caused significant disruption, necessitating a rapid shift to online learning and curriculum reassessment. This case study focuses on the redesign of a Thai business school's EE program. Data was collected through semi-structured interviews with participants and program managers. Key preliminary findings highlight the importance of C-level guest speakers, project-based learning, and a balance of practical and theoretical approaches. The study also underscores the value of online networking, strong alumni networks, and using COVID-19-related content as learning tools. The results suggest that business schools should integrate learning theories to foster innovation and adaptability, ensuring dynamic curricula and impactful research to meet the evolving global landscape.

The Icehearts Europe Implementation Guide to promote a mentoring programme for youth mental health

Abstract Issue/problem In Europe, 9 million young people (10-19) suffer from mental disorders and 70% of children and adolescents with mental health problems do not receive appropriate interventions at a sufficiently early age. Moreover, during the Covid-19 pandemic a high prevalence of depressive symptoms, anxiety and sleep disorders was observed in the population aged 4-19 years. The Icehearts Europe project (funding: EU4Health 2022 Programme) aims to disseminate at EU level a long-term programme for supporting health and wellbeing of disadvantaged children and adolescents. It is inspired by the Finnish best practice Icehearts, a 12-year long mentoring programme. Five pilot countries (Italy, Denmark, Spain, Slovenia, Estonia) will test the model to raise European awareness of how it works and to get more countries and organisations involved. Description of the problem Icehearts Europe is a preventive mentoring programme based on team sports, recreation and school support activities, with a child-centred community approach. To facilitate its implementation, a practical guide has been developed for grassroots sport and social promotion organisations to help them implement the model in their own contexts. The guide is the result of both a multisectoral cooperation between grassroots sport, health, universities, NGOs, and qualitative study activities (bibliographic research, study visit, group work, analysis of the situation and needs of local contexts). Results From February 2024 the Icehearts Europe Implementation Guide is available in six languages at https://www.icehearts.eu/resources. It is now being adapted by the Icehearts Europe partners into an online training programme for managers. Lessons The guide has incorporated lessons learnt from the Finnish model, considered as an evidence-based approach. It contains several operational tools to implement Icehearts Europe and can be adopted using different approaches: there is no one-size-fits-all solution. Key messages • Developed as a support to the Icehearts Europe piloting partners and as a basis for a fully-fledged online training programme for future Icehearts Europe managers. • To facilitate the implementation of early interventions to promote health and wellbeing of children and adolescents and enable them to cope with disadvantaged conditions.

Identifying the zero-dose and under-immunized children in Bangladesh: Approaches and experiences.

This paper presents and elaborates on empirical methods and approaches used to identify Zero-Dose (ZD) and Under-immunized (UI) children as well as the communities that these children reside in within Bangladesh. This paper also describes demand- and supply side-barriers that lead to children being ZD and UI in the country. Time period for the study was December 2022-May 2023. The study methodology encompassed secondary data analysis using data from national surveys, primary data collection and analysis via a lot quality assurance sampling (LQAS) survey and also, qualitative data collection and analysis. Study population included caregivers of children aged 4.5 months (4 months 15 days) to 23 months for the LQAS survey. The qualitative component included policymakers, program managers and service providers working in immunization as well as mothers in the selected study areas who had a living child aged less than 2 years as the study population. Our data analysis confirms existence of ZD and UI children in areas which were categorized into haor (wetlands), hilly, char (sandy/silty land surrounded by water), coastal, plain land and urban slums. Determinant analysis showed that the mother's level of education, antenatal visits made, and access to media were significantly associated with children being ZD or UI. Reproductive autonomy emerged as a key factor that had prominent impact on a child being ZD. The qualitative analysis indicated the importance of population migration, health workforce shortages and lack of access to transportation as prominent barriers to immunization. Notably, the methods and approaches used in this study are both effective and easily replicable to identify ZD and UI children. The drivers of ZD and UI along with the barriers to immunization provide potential areas for intervention by policy-makers and can apprise about interventions to be tested in future implementation research.

Understanding smoking cessation process in Tunisia from 2020 to 2023: description of quit attempts

Abstract Background Many smokers attempt multiple cessation methods before seeking specialist intervention. This study aims to describe these prior cessation attempts and identify relapse factors to enhance support for these individuals. Methods Data from 440 patients consulting the Department of Epidemiology Statistics at Abderrahman Mami Hospital from 2020 to 2023 were analyzed. It included information on previous quit attempts, methods used, longest duration of abstinence, number of attempts, reaction to cessation, and reasons for relapse. Statistical description was conducted using IBM SPSS 25. Results Among participants, More than half of the smokers had previously attempted to quit smoking 63,4%, with an average of 2 attempts ± 1,7 (0-10 attempts) per patient. The majority of patients (86.8%) quit smoking without using substitution methods. Among those who resorted to substitution, nicotine replacement therapy was the most frequently used method (n = 30; 6.8%). The longest duration of abstinence averaged 8 years. The main reaction to smoking cessation among patients was an improvement in their health (9,1%). The most common reasons for relapse were psychosocial problems (5.5%), followed by relapses during social events (4.3%), and withdrawal symptoms (3%). Conclusions This study emphasizes the importance of considering each patient’s journey during their smoking cessation process. Analyzing these factors will enable better management of the cessation program with the patient, as well as a deeper understanding of their feedback regarding our program, ensuring long-term cessation success. Key messages • Failed spontaneous quit attempts prior to NRT initiation are prevalent among smoking patients. • Understanding failed spontaneous cessation attempts can guide the development of more effective strategies.

Optimizing Colorectal Screening in Portugal with Process Mining

Abstract Background Efficient healthcare screening programs management influences patient outcomes. Process mining has emerged as a powerful tool to enhance these programs by refining complex workflows and pinpointing operational deviations. Objectives This study utilizes process mining techniques to analyze the colorectal cancer screening program in Northern Portugal, focusing on detecting deviations and performance bottlenecks in process models. Methods This screening program started in March 2018, but process mining was only used on data posterior to 2020. Over 1 million case observations from administrative data were included in the process model analysis, involving more than six key process activities and numerous resources. We used new software and statistical tools for process mining to rapidly compute observations and filter for different operational needs and monitor interventions. Results The discovery analysis identified deviations, such as unexpected performance issues and irregular activity sequences. Although over 100 traces were identified, fewer than five traces accounted for more than 90% of all case paths, indicating the most common traces that have a true impact in participation rates, referral rates, and treatment rates. Notable differences in resource performance during specific periods, such as COVID-19 or seasonal events, were also observed. These findings provided insights for adjusting resource allocation and improving coordination, with impact in minimizing seasonal phenomena or peak production periods. Lessons Process mining offers actionable insights for effective health program coordination, enabling the monitoring and timely response to process deviations. With key areas for action identified in a more timely and precise manner, we can enhance efficiency, and expand population coverage and treatment referral. Future initiatives will focus on further process optimization and national coverage expansion using these management tools. Key messages • Process mining revolutionizes healthcare by enabling the strategic management of complex oncological screening program workflows. • Comprehensive data analysis across the patient pathway enhances program efficiency and expands treatment access.

Handling client financial insolvency in maternity services: An occurrence, experience and policy gap qualitative analysis among healthcare stakeholders in North-Central Nigeria.

To assess the occurrence of client financial insolvency, experiences of key healthcare stakeholders, and policy gaps on handling the situation during maternity services. A qualitative study was conducted in North-Central Nigeria. Participants were key healthcare stakeholders including healthcare workers from private, primary, secondary, and tertiary facilities, healthcare administrators/facility-heads, program managers and policy makers at local and state government levels through In-depth and Key Informant interviews. Identified themes were occurrence, experiences of stakeholders, and prevention of client financial insolvency. Data were analyzed with the Nvivo statistical package. Participants confirmed the occurrence of client financial insolvency. Clients' inability to pay hospital bills was due to being indigent, awaiting support from relations, or clients who were uncommitted to the payment. Health facilities lack guiding policy documents; potential cases are referred from private to public or from primary to secondary/tertiary facilities. Methods of handling financial insolvency included healthcare worker-related (staff scavenging for needed consumables, fund-raising among facility staff), facility-related (revolving fund, medical social welfare, welfare committee, discharge with re-payment plan, fee-waiver), community-related (ward development committee, religious organizations/philanthropists) interventions, or hospital detention of insolvent clients. Although clients' bills did not increase during detention, many clients did not honor post-discharge re-payment agreements. Participants suggested a client-friendly billing system, early initiation of birth preparedness, partner involvement, and a rapid scale-up of health insurance for pregnant women to curb financial insolvency. Tackling client financial insolvency requires policy documents, support to private facilities, effective debt-recovery mechanisms, and scale up of health insurance for pregnant women.

Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya.

Management of undernourished children depends only on wasting yet it can coexist with underweight and/or stunting. Among children admitted to hospital with acute illness, we determined the proportion with wasting coexisting with underweight and/or stunting and their risk factors. A retrospective review of hospital records of children 6‒59 months old admitted at Garissa County referral hospital, Kenya, from January 2017 to December 2019 was conducted. Using World Health Organization 2006 growth standards, undernutrition were defined: wasting as Weight-for-height Z-score < -2, stunting Height-for-age Z-score < -2 and underweight Weight-for-age Z-score < -2. We studied wasting coexisting with underweight and/or stunting. Among 624 children recruited, 347 (56%) were males and 511 (82%) <24 months old. Diarrhoea 210 (34%) and pallor/anaemia 310 (50%) were the most frequent admission diagnosis. HIV infection was present among 8 (1.3%) children. Wasting, underweight and stunting were present among 595 (95%), 518 (83%) and 176 (28%) children respectively. 161 (26%), 506 (81%) and 161 (26%) children had wasting coexisting with stunting, underweight and both stunting and underweight respectively. In the multivariable regression, diarrhoea was positively associated with wasting coexisting with stunting (adjusted risk ratio [aRR = 2.96] [95% CI = 2.06‒4.23]) and anaemia with wasting coexisting with underweight (aRR = 1.23) (95% CI = 1.03‒1.47). Overall, 343 (55%) children were discharged alive, 67 (11%) absconded from the wards, 164 (26%) were transferred to another hospital and 50 (8.0%) died before discharge. The risk of inpatient death was 10.3%, 7.9%, 8.4% and 6.8% among children not wasted, wasted only, wasted & underweight, and wasted and underweight and stunted respectively (Chi-square p = 0.60). The study reports an unacceptably high levels of undernourishment, including coexisting forms of undernutrition among hospitalised children. This highlights a public health priority for current nutrition therapeutic care and need of continuity of care among those children discharged alive in the community-based management of acute malnutrition programmes.