Evaluation of the performance of a nutrition rehabilitation centre in a tertiary care hospital in Eastern India

Abstract

WHO)-UNICEF-World Bank (2015) joint estimate indicates that globally, the numbers of under-five children with wasting have remained high between 1990 and 2014, with the largest proportions of wasted children living in Asia (68.0%) and Africa (28.0%). 2 Odisha has a total population of approximately 42 million and an under-five population of approximately 3.7 million. According to the NFHS -4 conducted in 2015-16, at the national level severely wasted children comprise ABSTRACT Background: Severe acute malnutrition (SAM) places extraordinary challenges in the way of survival, growth and development of the child under five years of age. Our aim was to evaluate the functioning and performance of facility based management of SAM children admitted in the nutrition rehabilitation centre (NRC) and to identify the existing bottlenecks in the NRC. Methods: Children above 1 month and less than 5 years of age with severe acute malnutrition were included during the study period. Demographic details of the SAM children, clinical features during admission were recorded. Anthropometric measurements like MUAC, weight, height/length and WHZ scores were taken at admission and compared with the findings at discharge. Statistical analysis: the data after collection, compilation was analysed by SPSS. Results: Majority 277 (78.47%) of them belonged to rural areas. 300 (85%) SAM children were referred by medical officers. Bilateral oedema was recorded in 12 (17.9%) admitted children during 2014-2015, 22 (17.9%) children in 2015-2016 and in 37 (22.7%) children during 2016-2017. There was significant improvement in the mean weight (kg) and mean MUAC (cm) at discharge was in comparison to the weight and MUAC of the children at admission and this difference in increase in the mean weight and MUAC were found to be statistically significant. Conclusions: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however the frontline workers in the community and health care providers of PHCs should be trained and given hands on training for early identification and referral of SAM cases.

The effectiveness of facility-based management of children with Severe acute malnutrition and their determinants in Jharkhand, India: A retrospective study

“…Overall, an improvement in the anthropometric indicators following therapy at MTC was noted in the under-5 children with SAM although the effect size was modest. Similar findings were observed in other Indian studies that also reported a statistically significant increase in weight from the time of admission to discharge at the MTC/NRC [ [8] , [9] , [10] , [11] , [12] ]. Taneja et al found a statistically significant difference between the weight (t=14.552, P < 0.001) and MUAC (t = 9.548, P < 0.001) of children irrespective of gender at admission and discharge in a study that included data from 100 SAM-affected children admitted to seven different NRCs from the state of Madhya Pradesh in India.…”

“…The mean weight and MUAC at admission and discharge, for boys and girls separately, were found to differ statistically significantly [ 12 ]. Similar findings were observed in a study by Panda et al which included 353 Children with SAM admitted to a nutrition rehabilitation centre in Cuttack, Odisha [ 8 ]. The findings from the present study corroborate that from previous studies, and also indicate, the applicability of the NRC/MTC model in low-resource settings.…”

“…Within this state, a total of 96 malnutrition treatment centers (MTCs), equivalent to NRCs were functional as of 2021. There is a paucity of data on the effectiveness of NRCs/MTCs in the management of SAM in India with the data for Eastern states of India such as Jharkhand being especially scarce [ [8] , [9] , [10] , [11] , [12] ]. Therefore, this study was conducted with the objective of assessing the functioning and effectiveness of facility (MTC) based management of children with SAM in terms of their recovery (anthropometric indicators), adherence to discharge and follow-up guidelines.…”