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HealthPhone™: Part 1 - Severe Acute Malnutrition - Introduction - What is Severe Acute Malnutrition?

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Federal Ministry of Health

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What is Severe Acute Malnutrition?

What is acute malnutrition?

Acute malnutrition is a term used to cover both wasting and nutritional edema. Acute malnutrition results from a decrease in food consumption and/or illness, resulting in sudden weight loss or, bilateral nutritional edema.

A child age six months to 18 years has severe acute malnutrition if the following is present: Mid-upper arms circumference less than 11 centimeters, or presence of pitting edema of both feet.

A child age less than six months has severe acute malnutrition if the following is present: Visible severe wasting or presence of pitting edema of both feet.

Management of Severe Acute Malnutrition in Out-patient Therapeutic Programme

Out-patient Therapeutic Programme or OTP is used to treat children with severe acute malnutrition at the community level. To set up an OTP Programme, you will need the following therapeutic products,

medicines, and equipment.

Ready to use therapeutic foods. These are ready-to-use therapeutic foods that do not require preparation by the mother or the caregiver. They can be provided for the treatment of children with severe acute malnutrition on a weekly basis at health-post level, to be given for the children with severe acute malnutrition on a daily basis, at home.

Amoxicillin: This is an antibiotic for treating infections.

Mebendazole 100 milligrams. or Albendazole 400 milligrams. Mebendazole tablets are given to children for de-worming purposes. Treatment against parasites that compete for the child's nutritional intake is critical for successful treatment against malnutrition.

Folic acid. Folic acid is an essential micronutrient which helps to correct children's micornutrient status.

Vitamin A capsule. Vitamin A is important to boost the immune system of malnurished children, thereby increasing their capacity to fight diseases.

Measles vaccine. Measles can be deadly for malnurished children. Protecting them through vaccination can save their lives. Like with measles, malnurished children have an increased chance of dying if they contract malaria. It is therefore important to be prepared to treat malaria if it does manifest itself.

Plastic cups and a jerry can filled with drinking water should be available to last a month. Children should be offered drinking water when they are doing the appetite test for ready-to-use therapeutic foods.

One salter scale, 25 kilograms, plus pans or plastic basin for weighing children, is also required.

You will need at least two mid-upper arm circumference or MUAC tapes which you will use to measure the mid-upper arm circumference of children, who come to be screened, and for follow-up. Mid-upper arm circumference readings are accurate indicators of severe malnutrition in children between six months and five years old.

You will need a thermometer for checking the temperature of children. Children with fevers may require a referral to a health center for in-patient treatment.

Jerry cans with water for hand-washing purposes.

You will also need a hand basin and at least one bar of soap per month to keep caretakers' hands clean during appetite test. Careproviders should be informed to wash their hands before handling foods that will be eaten by children.

It is also important that you have a clean latrine at the health post, which can be used by children and care-providers when they come to the weekly OTP. Maintaining hygienic conditions will protect children from contracting illnesses like diarrhea, which can be deadly for malnurished children. Having a clean latrine at health post is also important for education purposes regarding hygiene.

You will also need stationery materials for the OTP Programme.

Each health post should have the OTP Quick Refernce Manual. This manual is designed to provide guidelines on each step of the OTP process and should be used to check on any procedures that you may have questions about.

You will need OTP cards which you will use to register and monitor the progress of children taking part in your Out-patient Treatment Programme.

The registration book will be required where you will document children who enter and leave the programme.

You will need referral slips which you will use to refer patients with medical complications to therapeutic feeding units or in-patient units. You will also need referral slips which volunteer community health workers will use to refer children to the health post or OTP.

Stock cards or supply register is required to track your use of supplies. You'll have to make sure they are available to adequate supplies before the date of the weekly OTP.

Taking good care of your supplies is critical for your Out-patient Therapeutic Programme. Supplies should be placed in a cool and dry place. Place items on pallets and protect windows and doors against rodents. Maintaining the cleanliness of your working environment and supply storage area are critical factors for success. In order to monitor the OTP properly, you need to produce the timely monthly report using the monthly therapeutic feeding programme report form. You have to send the report to the Woreda Health Office, keeping a copy for the health post.

Video Details

Duration: 6 minutes and 32 seconds
Year: 2009
Country: Ethiopia
Language: English
Producer: Federal Ministry of Health and UNICEF, Ethiopia
Views: 3,784
Posted by: nand on Feb 12, 2012

Intended for Health Extension Workers (HEW) on how to do screening for malnutrition, how to identify Severe Acute Malnutrition cases; and how to conduct Out-Patient Therapeutic Programme for SAM in order to maximize the coverage and improve the quality of services provided to SAM cases at the community level.

Management of Severe Acute Malnutrition and Out Patient Therapeutic Program Training Material - Federal Ministry of Health and UNICEF, Ethiopia

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