Outcome Evaluation of Community Management of Severe Acute Malnutrition in Some Selected Outpatient Therapeutic Programme Centres of Katsina State, Nigeria

Abstract

Severe acute malnutrition remains a major public health problem, especially in developing countries. In this study, a retrospective and on-site assessment of the effectiveness of the community management of acute malnutrition (CMAM) program in four (4) Outpatient Therapeutic Programme (OTP) centres of Katsina and Daura Local Government Areas of Katsina State was carried out from January 2021 to December 2021.  Assessment of CMAM performance indicators, anthropometric indices, oedema, the biochemical and haematological status of children with severe acute malnutrition (SAM) and a follow-up assessment of probable relapse 8 weeks after discharge was carried out. The result indicated that both the treatment (87.90% and 94.44% at Katsina and Daura OTPs respectively) and geographical coverage (20.00% at both Katsina and Daura OTPs) in the present study were higher than the values for the retrospective study.  Outcome measures of CMAM in the Katsina OTPs showed a cure rate of 95.0% and 97.3% in the retrospective and current studies, respectively. While in Daura OTPs, the cure rates were 86.8% and 93.52% respectively for the retrospective and the present study. Result for the growth performance and recovery indices have shown higher percentages in normal range values for mid upper arm circumference, weight for height and Oedema among the SAM children at the point of discharge over the values at the admission. In fact, all the children that presented with oedema in both OTPs at admission did not have oedema at the point of discharge. In addition, there was a significant improvement in biochemical and hematologic indices in SAM children at discharge compared to the values at admission ​​(p < 0.05).  Findings of the study have indicated a good performance of CMAM program in OTP centers of Katsina and Daura Local Government Areas of Katsina State as prescribed by the SPHERE standard.