Utilization of Guidelines for Management of Severe Acute Malnutrition in Children Aged 6-59 Months in Busia County Referral Hospital

Abstract

Background: Malnutrition is responsible for 35% of deaths among children under five years of age globally. The prevalence of severe acute malnutrition in Kenya is estimated to be 6%. In Busia County Referral Hospital case fatality rate for children with severe acute malnutrition in 2014 was 26%. World Health Organization (WHO) has developed guidelines for the management of severe acute malnutrition in children. The use of these guidelines in treatment of children with malnutrition reduces mortality related to malnutrition. Objective: The objective of the study was to assess the utilization of guidelines for management of severe acute malnutrition in children aged 6-59 months in Busia County Referral Hospital. Methods: This was cross-sectional, descriptive study. Purposive sampling was used to select the study sample. A checklist was used to verify documentation of guidelines for management of malnutrition in children from the in-patient files. An overall guidelines utilization scoring tool was developed and used to rate the overall utilization of the guidelines. Data on the supply of essential nutritional commodities was obtained through key informant interviews. Descriptive data was analysed using mean, mode and median. Findings were presented in form of frequency tables and bar charts. Results: A total of ninety-six (96) participants were recruited for the study. The mean age of the participants was 21.85 months. There was significantly higher proportion of children with MUAC less than 11.5cm among 6 to 12 months 20(69.0%) [OR=9.26; 95%CI=2.82-30.39; P<0.001] and 13 to 24 months 16(44.4%) [OR=3.33; 95%CI=1.10-10.09; P=0.033] compared to those aged 25 to 59 months 6(19.4%). Mean weight had increased from 7.97Kg at admission to 8.45Kg at 7 days and this difference was significant (p<0.0001) after paired samples t test was computed. The average utilization of the guidelines was 86.4%. Conclusion and recommendations: Guidelines for management of severe acute malnutrition were adequately utilized in Busia County Referral Hospital. Periodic training of all health workers involved in the care of children with severe acute malnutrition was recommended to ensure optimum utilization of the guidelines for management of severe acute malnutrition.

Keywords: Utilization, Guidelines, Severe acute malnutrition, management, under five years.

DOI: 10.7176/JHMN/86-03

Publication date: February 28^th 2021