© 1984 by Oxford University Press
research-article |
Management of Severely Malnourished Children by Village Workers in Integrated Child Development Services*in India
Four thousand two hundred and ninety-two children with severe protein calorie malnutrition were managed by village level workers at village centres. Treatment included provision of 700 to 900 calories and 15–20 g protein as supplement to the breast milk and weaning food being received at home and simple drug therapy for associated diseases. Eighty-five per cent children improved, 6.3 per cent had no change, 3.6 per cent deteriorated, 3.0 per cent died and 2.1 per cent were lost to follow up. Diarrhoea, short fever and apparent respiratory illness were associated illnesses contributing to the death in 42.6 per cent, 38.0 per cent and 34.9 per cent of fatal cases. Prevalence of severe malnutrition and fatality were higher in younger children less than 3 years of age compared to older ones between 3 to 6 years of age. Referral from village centre to larger health facilities was not utilized by majority of the relatives of the sick children. It is concluded that village level management of severely malnourished children by a local worker is an acceptable and effective approach and low cost. It is recommended for countries with endemic protein-calorie malnutrition.