Assessment of Performance of Community Management of Acute Malnutrition in Batsari Local Government Area of Katsina State, Nigeria
Assessment of Performance of Community Management of Acute Malnutrition in Batsari Local Government Area of Katsina State, Nigeria
ABSTRACT
Community Management of Acute Malnutrition (CMAM) is a community-based integrated approach to management of acute malnutrition.
Retrospective and on the spot (present) assessment of performance of community management of acute malnutrition program was carried out in two Outpatient Therapeutic Programme (OTP)
centers at Wagini and Batsari communities of Batsari local government area of Katsina state with the aim of assessing the performance of the programme in the locality.
Access, coverage and other performance indicators of CMAM programme, biochemical and haematological parameters of 435 children with Severe Acute Malnutrition (SAM) and relapse rate among SAM children were among the indices assessed using standard methods.
For the retrospective study, data already available at the OTP centers were collected and used while for the present study, severe acute malnourished children admitted into the OTP were monitored for 8-week period within which their anthropometric and biochemical data were collected.
TABLE OF CONTENT
Title Page – – – – – – – – – – i
Dedication – – – – – – – – – – ii
Certification – – – – – – – – – – iii
Declaration – – – – – – – – – – iv
Acknowledgement – – – – – – – – – v
Table of Contents – – – – – – – – – vi
List of Tables – – – – – – – – – – vii
List of Figures- – – – – – – – – – viii
List of Abbreviations – – – – – – – – – ix
Abstract – – – – – – – – – – x
1.0 INTRODUCTION – – – – – – – – 1
1.1 Statement of Research Problem – – – – – – 4
1.2 Justification – – – – – – – – – 4
1.3 Aim and Objective – – – – – – – – 5
1.3.1 Specific Objectives – – – – – – – – 5
1.4 Hypothesis – – – – – – – – – 6
2.0 LITERATURE REVIEW
2.1 Nutritional Status – – – – – – – – 7
2.2 Malnutrition – – – – – – – – – 7
2.2.1 Conceptual framework for Causes of Malnutrition – – – 10
2.3 Severe Acute Malnutrition – – – – – – – 12
2.4 Global Severe Acute Malnutrition – – – – – – 13
2.5 Prevalence of Malnutrition – – – – – – – 13
2.6 Management of Acute Malnutrition – – – – – – 14
2.7 Target Group for Community Management of Acute Malnutrition- – 15
2.8 Performance Indicators of CMAM Programme– – – – 15
2.9 CMAM Programme Coverage Rate- – – – – – – 15
2.10 Community management of Acute Malnutrition- – – – – 16
2.11 Principle of Community Management of Acute Malnutrition- – – 18
2.12 Advances that made CMAM Possible – – – – – – 20
2.13 A new Classification of Acute Malnutrition – – – – – 20
2.14 Community Based Management of Severe Acute Malnutrition – – 22
3.0 MATERIALS AND METHODS – – – – – – 25
3.1.1 Materials – – – – – – – – 25
3.1.1 Study Area – – – – – – – – – 25
3.2 Method – – – – – – – – – 25
3.2.1 Designed of study – – – – – – – 25
3.2.2 OTP Sampling- – – – – – – – – 28
3.2.3 Subject- – – – – – – – – – 28
3.2.4 Ethical Clearance- – – – – – – – – 28
3.2.5 Anthropometric Measurements – – – – – – 28
3.2.5.1 Weight – – – – – – – – 29
3.2.5.2 Height/ length- – – – – – – 29
3.2.5.3 MUAC – – – – – – – – – 30
3.2.6 Oedema – – – – – – – – – – 32
3.2.7Determination of Some Biochemical and Haematological Parameters – 30
3.2.7.1 Blood Collection – – – – – – – – 30
3.2.7 .2 Packed Cell Volume (PCV) – – – – – – – -30
3.2.7. 3.HaemoglobinConcentration (Hb) – – – – – – 31
3.2.7.4 Determination of Glucose Concentration – – – – – 31
3.2.7.5 Determination of Serum Albumin – – – – – 32
3.2.8 OTP Performance Indices – – – – – – – 32
3.2.8.1 Cure rate – – – – – – – – – 32
3.2.8 2 Death rate – – – – – – – – – 32
3.2.8.3 Default rate – – – – – – – – – 32
3.2.8.4 Non recovery rate – – – – – – – – 32
3.2.9 Determination of Access and Coverage of the CMAM Programme – – -33
3.2.9.1 Treatment Coverage – – – – – – – – 33
3.2.9.2 Geographical Coverage – – – – – – – 33
3.2.9.3 Point Coverage – – – – – – – – 34
3.2.9.4 Period Coverage – – – – – – – – 34
3.2.10 Relapse rate Determination – – – – – – – 34
3.2.11 Data Analysis – – – – – – – – – 34
3.2.12 Performance and Quality of CMAM Services – – – – 35
4.0 RESULT/DATA PRESENTATION AND ANALYSIS – – – 38
4.1 Coverage – – – – – – – – – 38
4.2 OTP Performance Indicators – – – – – – – 38
4.3 Growth and recovery performance of SevereAcuteMalnutrition Children – 41
4.4 Biochemical and Haematological Indices of SevereAcuteMalnutrition Children 43
4.5 Relapsed Rate – – – – – – – – 49
5.0Discussion – – – – – – – – 54
6.0 Conclusion and Recommendation – – – – – 57
6.1 Conclusion – – – – – – – – 57
6.2Recommendations – – – – – – – – 57
REFERENCES – – – – – – – – 59
APPENDICES – – – – – – – – – 64
INTRODUCTION
Malnutrition generally refers both to under nutrition and over nutrition. Many factors can cause malnutrition, most of which relate to poor diet or severe and repeated infections, particularly in underprivileged populations.
Inadequate diet and disease, in turn, are closely linked to the general standard of living, the environmental conditions and whether a population is able to meet its basic needs such as food, housing and health care (Elia, 2000).
Malnutrition is thus a health outcome as well as a risk factor for disease, exacerbated nutrition and can also increase the risk both of morbidity and mortality (Stratonet al.,2003).
Although it is rarely the direct cause of death (except in extreme situations, such as famine), child malnutrition was associated with 54% of 10.8 million children deaths in developing countries in 2001 (WHO, 2001).
Nutritional status is clearly compromised by diseases with an environmental component, such as those carried by insect or protozoan vectors, or those caused by an environment deficient in micronutrients.
The effects of adverse environmental conditions on nutritional status are even more pervasive. Environmental contamination e.g. destruction of ecosystems, loss of biodiversity, climate change, and effects of globalization have contributed to an increasing number of health hazards (Johns and eyzagurre, 2000).
REFERENCES
Adair, L. and . Polhamus,B. (1998). Testing Indicators for Use in Monitoring Interventions to
Improve Women‟s Nutritional Status. Measure Evaluation Project, the United Nation,
University Press. 50-80.
Bender, W., and Remancus,S. (2000) The Anthropometry Resource Centre Funded by the
FAO/SADC Project GCP/RAF/284/NET, Development of a Regional Food Security and
Nutrition Information System, p70-90
Blakely T, Hales S, and Woodward A. (2004). Socioeconomic status: assessing the distribution
of health risks by socioeconomic position at national and local levels.3-34.
Chan Y. C., Suzuki M.,and Yamamoto S. (1997) Dietary, Anthropometry, heamatological and
Biochemical Assessment of Nutritional Status of Centenarians and Elderly people in
Okinawa, Japan J. Am Coll. Nutr., 16(3): 229-235.
Chevassus – Agnies, S. (1999) SD Dimension Sustainable Developments Department, Food and
Agricultural Organization of the United Nations, Anthropometric Health and
Demographic Indicators in Assessing Nutritional Status and Food Consumption.p56.
CMAM (2012) Comprehensive set of tools, articles and presentationsbased on a recent coverage
workshophttp://www.validinternational.org /coverage/resourcekit.zip
