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ASSESSMENT OF OUTPATIENT THERAPEUTIC PROGRAMME FOR SEVERE ACUTE MALNUTRITION IN THREE REGIONS OF ETHIOPIA

T. BELACHEW, H. NEKATIBEB

Abstract


ABSTRACT
Objective: To document the experiences and lessons for rolling out of the OTP
service at the wider scale with the aim of assessing the strengths and weaknesses of
the project and suggest recommendations for future programming.
Design: Qualitative methods of data collection including focus group discussion,
observation and in-depth interview of key informants were employed to get relevant
data. Review of health facility, reports and programme documents were done to
capture further- information.
Settings: Out Patient Programme (OTP) pilot programme implemented by
CONCERN/VALID in three administrative regions of Ethiopia namely: South
Nations and Nationalities Peoples Regions (SPNNR), Addis Ababa and Oromia
regions. A total of thirteen health centres which had started OTP service from the
three regions were included in the study.
Subjects: Thirty six key informants and 30 focus group discussants were involved in
the study conducted from 16th to 25th November 2006.
Results: Out Patient Programme (OTP) has enhanced community’s understanding
of malnutrition as a health problem through an excellent entry point it created for
behaviour change communication (BCC) on optimal lnfant and young child feeding
(IYCF). It has also enhanced utilisation of the existing equipments of the respective
health services to promote nutrition and increased mental satisfaction of the
providers who observed rapid recovery of malnourished children taking the plumpy
nut. It also resulted in increased awareness of the community about malnutrition
and its treatment, which resulted in increased need-based demand for the OTP and
self-referral of children to health facilities. Shift in the thinking of the providers on
the fact that malnutrition can be treated without admitting the child and reduction
in the burden of malnutrition and associated mortality are other positive findings of
the study.
Conclusion: While it was observed that the programme was very effective in treating
case of severe acute malnutrition and is highly acceptable by planners, health care
providers and beneficiaries, there were different operational issues that needed to
be strengthened. The irregularity and incompleteness of supply availability, high
attrition of trained human power, inadequate supportive supervision especially
from local ministry of health, inadequate community mobilisations are some of the
shortcomings identified. Based of these findings recommendations were forwarded.

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The East African Medical Journal is published monthly by Kenya Medical Association.

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