Describe the Out-patient feeding program

Selective feeding programmes have been revolutionized by the development of ready-to-use-
therapeutic-foods (RUTF). Home-based therapy using RUTF has reduced the need for feeding
centres thereby allowing children to be treated in the community. This has led to far greater
coverage and has prevented overcrowding in centres where the risk of epidemics is high.
Objectives of therapeutic care
The main objective of therapeutic care is to save the lives of individuals with severe acute
malnutrition (SAM). Severe acute malnutrition is a complex medical condition that needs
specialized care to save the patient’s life. It can be identified using anthropometry (body
measurements). Therapeutic care programmes can obtain very high recovery rates (above 80 or
90 per cent) and reach most malnourished individuals in the community.

Components of OTP
Acutely malnourished children are identified in the community or directly in a health facility.
Three forms of treatment are provided according to the severity of the child’s condition;
1. Individuals with moderate acute malnutrition and no medical complications are supported in
a supplementary feeding programme (SFP) that provides dry take-home rations and standard
medicines. The objectives of SFP programmes are to decrease the incidence of severe acute
malnutrition and treat moderate acute malnutrition. Technically, this is not therapeutic care,
but SFPs are usually linked to therapeutic care during emergencies.
2. Individuals with SAM with no medical complications are treated in outpatient care sites
(health centres or posts), with RUTF and routine medicines. These are taken at home, and the
child attends the outpatient care site weekly or biweekly.

Admission criteria
Several admission criteria are currently used for deciding which children should be admitted to
therapeutic care. All are based on the use of weight-for-height and/or mid-upper arm
circumference (MUAC) and presence of bilateral oedema.

Treatment protocols
Routine medicines are given on admission. Vitamin A and folic acid are recommended only for
children with marasmus presenting specific deficiency symptoms, or when there is high risk of
deficiency (e.g., during an outbreak of measles).
Routine antibiotics are given to all children, given the high prevalence of silent infection in cases of severe malnutrition. A curative course of anti-malarials is often included in areas of high malaria prevalence. Children over nine months are usually vaccinated against measles.

Medical treatment
Routine medical treatments for those admitted to ESFP are recommended. Patients referred from
a therapeutic care programmes will already have received treatment. Usual treatments include:
1. Supplementation with vitamin A on admission
2. Treatment of all children for worm infections
3. Measles vaccination for all children between 9 months and 15 years of age
4. Supplementation of iron and folic acid on admission and then administered weekly

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Titany answered the question on November 11, 2021 at 13:27