Management of children with severe acute malnutrition: experience of Nutrition Rehabilitation Centers in Uttar Pradesh, India.

ABSTRACT

OBJECTIVE: To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in Nutrition Rehabilitation Centers (NRC). DESIGN: Review of data. SETTING: 12 NRCs in Uttar Pradesh, India. PARTICIPANTS: Children admitted to NRCs (Jan 1, 2010 - Dec 31, 2011). INTERVENTION Detection and treatment of SAM with locally-adapted protocols. OUTCOMES: Survival, default, discharge, and recovery rates. RESULTS: 54.6% of the total 1,229 children admitted were boys, 81.6% were in the age group 6-23 months old, 86% belonged to scheduled tribes, scheduled castes, or other backward castes, and 42% had edema or medical complications. Of the 1,181 program exits, 14 (1.2%) children died, 657 (47.2%) children defaulted, and 610 (51.7%) children were discharged The average (SD) weight gain was 12.1 (7.3)g/kg body weight/day and the average (SD) length of stay was 13.2 (5.6) days. 206 (46.8%) children were discharged after recovery (weight gain >15%) while 324 (53.2%) were discharged, non-recovered (weight gain <15%). CONCLUSIONS: NRCs provide life-saving care for children with SAM; however, the protocols and therapeutic foods currently used need to be improved to ensure the full recovery of all children admitted.