Effectiveness Of Nutritional Rehabilitation in Severe Acute Malnutrition Children Admitted to District Nutrition Rehabilitation Center

Background: Malnutrition among under-five children is a major public health problem in India. Severe acute malnutrition is responsible for high morbidity and mortality, serious long term sequelae in children between 6 months to 59 months. Children with severe acute malnutrition require immediate attention along with proper nutritional rehabilitation not only to decrease mortality but also to achieve full potential after recovery. In addition to critical care, a nutritional therapy followed by nutritional rehabilitation is a very important aspect for these children.

Methods: A hospital based simple prospective observational study, was carried out among 75 SAM children during the period from January 2021 to January 2022, in District NRC, VIMS Ballari. SAM children were fed in appropriate composition and quantity as per Indian academy of paediatrics guidelines (initial and rehabilitation phase;F75, F100 and staple food). All children were assessed daily for weight gain, improvement in clinical status, feeding problem, compliance with the treatment and improvement in the appetite. The effectiveness of nutritional rehabilitation at NRC assessed according to criteria and documented. All the data statistically analysed.

Results: A total of 75 SAM children were included in the study over the duration of 13 months. Majority i.e., about 30.7% belonged to the age group of 24-35 months. About 53.3% of children were males, and 74.7% were from lower middle class. About 53.4% of children gained weight of average 5-10 g/kg/day. The mean duration of stay was 12.45 days with a standard deviation of around 4.21 days. After the completion of 4 follow-ups, all children had gained weights, which confirm the efficiency of the nutritional rehabilitation centre. Overall, the recovery rate was 90.6%, non-responders were 9.4%, 1child was defaulter in the program, 5 children had relapse and no mortality was noted.

Conclusion: The interventions provided in the NRC have effectively improved the nutritional status of admitted SAM children as observed by the significant average weight gain. The benefits of the intervention were not sustained following discharge due to increased drop-out rates, and lack of compliance