child health presentation

1. Primary Level Care of
Malnutrition
Hafsa Parpia and Congo Dismas
Facilitator : Prof F. E Onyango

2. Objectives
• Classification
• Epidemiology
• Causes
• Community management

3. Classification
Malnutrition
Under
Acute
(Wasting)
Chronic
(Stunting)
Over
Overweight
(> +2SD)
Obesity
(> +3SD)

4. Acute Malnutrition – Risk Factors
• Low socio-economic status
• Poor feeding practices – inadequate
breastfeeding or complementary feeding
• Persistent diarrhoea
• Chronic infections – TB, HIV
• Lack of adequate parental information
• Malignancy

5. Causes

6. Percentage of Children classified as malnourished - KDHS
Height-for-Age
(Stunting)
Weight-for-height
(Wasting)
Weight-for-Age
(Underweight)
2000 2008-9 2000 2008-9 2000 2008-9
Sex Male 37.9 30.8 6.6 6.7 22.6 20.7
Female 32.6 28.3 5.3 4.9 19.6 19.8
Residence Urban 26.6 21.6 3.3 4.6 12.4 12.6
Rural 38 31.2 6.8 6.1 23.9 21.8
Mother’s
Education
None 37.2 34.2 7.1 12.8 24.1 34.5
Primary Not
available
29.8 Not
available
4.6 Not
available
23.5
Secondar
y
25.6 19.3 3.4 3.0 13.7 10
Total 35.3 29.6 6 5.8 21.2 20.3

7. Interpretation
• More prevalent in the male gender
• Higher in rural areas
• Higher among mothers with no education
• Generally decreased with time

8. Community Management
• Community Health worker – screen with
MUAC, oedema assessment

9. Community Management
• Ready-to-Use Therapeutic Food
• Monitor after two weeks for three months

10. Community Health Education
• Optimal breastfeeding
• Optimal complementary feeding
• Feeding sick/malnourished children
• Maternal nutrition
• Micronutrient supplementation – folate, iodine,
Vitamin A
• Growth monitoring
• Hygiene and sanitation
• De-worming

11. Hospital Management
1. hypoglycaemia
2. Hypothermia
3. Dehydration
4. Electrolytes
5. Infection
6. Micronutrients
7. Feeding
8. Catch-up growth
9. Stimulatory environment
10. Prepare for discharge

12. References
• Primary health care manual 3rd edition
• IMAM guidelines: www.unicef.org
• Class note by Prof. Nduati