Clinical Outcome and Sociodemographic Determinants of Community-based Rehabilitation of Severe Acute Malnourished Children in the Jabalpur District of Madhya Pradesh, India

Abstract

Background: The initiative for managing severe acute malnutrition at the community level was officially launched statewide in Madhya Pradesh in 2020 as the part of the Poshan Abhiyan. Objectives: The current study was carried out to examine the clinical outcome of the dietary interventions given to Severely Acute Malnourished (SAM) children receiving community-based rehabilitation named as C-SAM and determining its association with sociodemographic and feeding practices. Materials and Methods: An observational and prospective study was conducted on 400 children aged 6 months to 59 months. Interview of mother/caretaker was done to elicit the information regarding sociodemographic details and feeding practice of child using a structured and pretested questionnaire. Anthropometric assessment was done during home visit and documentation of the weight and height/length of the child was done. The outcome was assessed as cured/recovered, not recovered, defaulter, and death as per the recommended guidelines. Results: The age group of 13–24 months had the highest percentage of SAM children (37.1%). After 12-week duration in C-SAM, 44.8% of study participants were found to be recovered and 7% required Nutrition Rehabilitation Center referral. The age of the child, mother’s age at childbirth, father’s education, exclusive breast feeding, and optimum feeding practices are found to be significantly associated with the outcome. On the follow-up, appreciably, no weight loss was observed in discharged children and 26 children among nonrecovered also gained recovery. Conclusion: The clinical outcome observed therein shows the recovery with the 12-week protocol in less than half of the participants thus the strategy may be extended till the time child is gaining recovery.