Outcome and cost effectiveness of inpatient care of malnourished underfive children in district hospitals of Mwanza region

Abstract

Background: Malnutrition is a disease affecting commonly children from 0 to 5 years of age; however other age groups are not exempted, hospitalized cases are accompanied with high case fatality rate especially those not using WHO therapeutic regime guide line, for those using WHO regime the case fatality rate can be reduced to less than 5%, malnutrition secondary to other diseases like Tuberculosis and HIV/AIDS also respond fairly on WHO regime especially when using the right regime of treatment for the respective disease. Malnutrition in Tanzania is still a problem with prevalence of 36% and mortality of 28%, hospital case fatality rate differs from one hospital to another, this study reveals the prevalence and case fatality rate in all district hospitals of Mwanza.
Objective: To compare the out come and cost effectiveness of therapeutic regime used by different district hospitals in the management of malnutrition of under five years children in Mwanza region
Methods: Design, Cross sectional analytical study and retrospective study was done. Thus Cross sectional study was done to all under five years children admitted with malnutrition in children ward. Descriptive analytical study was also applied, to all the records from files of admitted cases from 2009 to 2011 was collected as secondary data.
Results: The study reveled that malnutrition is still high as it has a prevalence of 30% With case fatality rate ranging from 8.8% for the health facilities using WHO regime, and case fatality rate (CFR) of 29% for health facilities not using WHO regime (but using other therapeutic regime) . It was also observed that no malnutrition screening test or Screening Nutrition Assessment Questionnaire was used in all district hospital except at three hospitals (37.5%)
Conclussion: Malnutrition is still a public health problem with high mortality rate Which is attributed by failure to use WHO protocol which can reduce case fatality rate significantly, this has been practiced and found to be effective in Rwanda and Malawi and many other countries, another factor is shortage of trained staff on WHO protocol in health facilities also failure to undertake Malnutrition Screening Test (MST) or Screening Nutrition Assessment Questionnaire (SNAQ ) in health facilities, this is important in making early diagnosis other wise it is difficult to capture malnutrition in early stage,

Key words: Prevalence, case fatality rate of malnutrition, use WHO therapeutic regime