Management of Severe Acute Malnutrition in Day Care Settings: Findings from Innovative Public Private Partnership at Devbhumi Dwarka District, Gujarat

Abstract

Introduction: Severe Acute Malnutrition (SAM) is a major public health concern that is linked to a high mortality rate in children under the age of five. Government of Gujarat has expanded treatment network from government facilities to private institutions and non-governmental organizations through various initiative in an effort to address the issue of SAM. Objective: To assess the treatment outcome among SAM children (0-5 years) admitted at Niramay Bal Poshan Kendra, Jam Khambhalia, Devbhumi Dwarka District of Gujarat. Method: A longitudinal study was conducted among SAM children admitted at The Niramay Bal Poshan Kendra (Public Private Partnership model under Bal Poshan Yojana) which is a day care center providing treatment to SAM children for 14 days according to the protocol of NRC (Nutrition Rehabilitation Centre). Under Bal Poshan Yojana, RBSK medical officers screened children for SAM and referred them for treatment at empanelled NGO/Private institution. Total 1557 under five children were screened by them between 6th September 2021 and 5th February 2022. Out of them 121 SAM children were identified, 95 children could be mobilized at the study site (Niramay Bal Poshan Kendra). Out of 95 children, 76 SAM children completed the treatment along with all three follow up at the study site. The data of these 76 Children was analyzed. Results: Among 76 children, average weight gain was 566 grams at the time of discharge and 1000 grams at the time of third follow-up. An average weight gain for the cohort is 5.2 gram/kg/day. At the end of treatment, 92% children moved out of the SAM category at the completion of three follow-up, 55% moved to Moderate Acute Malnutrition and 37% to normal weight category. Conclusion: An average weight gain among the study population was satisfactory. Day care treatment model provides advantage of improved treatment completion rate and higher follow-up completion. Similar models of SAM treatment can help in effectively tackling menace of malnutrition in Gujarat.