Treatment Outcomes of Outpatient Therapeutic Feeding Program and it’s Determinants in Enderta woreda, Tigray region, Ethiopia

Abstract

Background: Ethiopia has long history of food insecurity and nutritional problems affecting large proportion of the population caused by successive droughts. Even during the relatively good non-drought seasons, levels of malnutrition in children and women in Ethiopia were extremely high. Outpatient therapeutic feeding program, which is one of the nutritional intervention programs, is used to treat severe acute protein energy malnutrition without complication. In Tigray Region the recovery rate (72%) and defaulter rate (8.8%) of outpatient therapeutic feeding program were below the Sphere standards. Objective: To asses treatment outcomes of outpatient therapeutic program and its determinants among malnourished children in Enderta woreda, Tigray, Ethiopia, 2012. Methods: A prospective institution based cohort study was employed. The respondents were 332 children of 6-59 months age who were routinely admitted to OTP providing health facilities and their mothers/caregivers in Enderta woreda, Tigray Region from January-April, 2012. After determining the average number of admissions for each of the 11 health facilities; the sample size was proportionally allocated according to their size and selected consecutively. Results: Concerning the outcomes of treatment, 255 patients (76.8%) have recovered, with a median time to recovery of 49(28–56) days and mean rates of weight gain were 8.3 (±3.7) g/ kg/ day. Fifty eight patients (17.5%) defaulted and their median stay in the programme was 28 (14– 49) days. This study showed that, the Mean weight for height and mid upper arm circumference while defaulting were 73.3(±6.5) and 11.3(±0.7) res pectively. The Kaplan Meier survival curve showed difference in time to recovery in variables such as: sex of the child, age of the child, weight/height of the child at admission, maternal age at first marriage, distance of health facility, means of water storage at home way of food preparation for < 5 children . All these variables had statistically significant association with treatment outcome of malnutrition on multiple variable proportional hazard Cox model except age of the child and way of food preparation. Conclusions and recommendations: Treatment outcomes in terms of recovery rate, death rate and non response rate were within the sphere standards but the defaulter rate, mean length of stay and weight gains were below the sphere standards. Sex of the child, , weight/height of the child at admission, maternal age at first marriage, distance of health institution and means of water storage at home were the independent predictors of treatment outcomes. To reduce childiv mortality and morbidity from mal nutrition; it is better to direct efforts to address the high defaulter rate, longer length of stay and low weight gain