Summary:

Fighting malnutrition from hospital to home.

At a Children’s Nutrition Unit in Bangladesh, a screening process has been developed to determine the type of care which should be provided to malnourished children. Malnourished children receive an initial period of full-time medical attention if they exhibit apathy and anorexia, dehydration, severe anemia, life-threatening infection, hypoglycemia, hypothermia, or severe Vitamin A deficiency. Also, malnourished children under 12 months old are given preference for in-patient care. Children may be hospitalized for three to five weeks until they are reasonable recovered and have reached a target weight-for-height or they may be discharged early and receive continued treatment through day care or home visits. Goals of the minimum stay (one to two weeks) should include restored appetite, treatment of clinical complications, and teaching the mother about appropriate feeding. Hospitalization and day care in the hospital may be very difficult for a family to manage. Home-based treatment, on the other hand, produces good, although slower, results and is the most cost-effective approach. Success of home care depends upon the quality of care and advice given during home visits by health personnel and an effective referral system if the children need more attention. In this program, while the provision of a Vitamin and mineral mixture is considered helpful, food supplements are not distributed. Even very poor families can adapt family foods to provide better nutrition. Less malnourished children also need attention, and their mothers must be trained to adapt family foods, give frequent meals, and continue to breast feed. Action is needed when growth begins to falter to prevent the need for later treatment. In Dhaka, the total cost to rehabilitate one child is US$29 for home-based care, US$59 for day care, and US$156 for in-patient care.

Authors: Ashworth, A.; Khanum, S.

Journal: https://www.ncbi.nlm.nih.gov/pubmed/12291332