The Effectiveness of Locally-Prepared, Home-Made Food in the Outpatient Management of Children with Moderate, Severe and Acute Malnutrition


ABSTRACT:BACKGROUND:Severe acute malnutrition (SAM) affects nearly 20 million preschool-age children. Malnutrition isa risk factor in approximately one third of deaths in children who are under 5 years of ageworldwide. Outpatient treatment of uncomplicated (SAM) is increasingly provided, using ready-tousetherapeutic foods (RUTF) & home-based management with locally homemade food.OBJECTIVE:To evaluate the effectiveness of Iraqi locally-prepared, home-made food in outpatient managementof moderate and SAM in children aged 6-59mo, and to assess foods complying with specificnutritional compositions of standard ready-to-use therapeutic foods (RUTF), recommended byWHO.PATIENTS AND METHODS:This is a Hospital-based cross sectional study was conducted at Fatema Al-Zahraa Hospital forMaternity and Children in Baghdad from 1st Jan 2018 to 31st Dec 2018 in an attempt to assessthe use of locally-prepared, home-made food prepared high energy-dense food in outpatientmanagement of moderate acute malnutrition (MAM) and SAM in form of four recipes which weredesigned in nutrition research institute, MOH. This is done by following the weight and length orheight of (76) patients with MAM or SAM every two weeks depending on WHO growth standards;Weight-for-Length (W/L) or weight-for-height (W/H) Reference Card.RESULTS:The total number of patients who completed the study were 76; 31 (41%) males and 45 (59%)females. The most common age group was 6 -12 months 51 (67.1% ) with a relatively MAMpredominance 43(56.6%) patients, over SAM 33(43.4%) patients. The recovery rate was 66 patients(86.8%) while 10 patients (13.6%) were referred to inpatient treatment. The wt. gain was > 5 g/kg/din 34 (51.5%) patients and <5 g/kg/d in 32 (48.5%) patients with mean (5.2±1.37) which isconsistent with WHO recommendations. The mean duration of treatment was (5.93 ± 2.63) weeks.CONCLUSION:A locally homemade prepared food is highly relevant and it is good alternative and might be used assubstituent for imported RUTF in outpatient management of acute malnutrition.