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Performance Indicators for SAM OTP with no SFP program

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 3 replies. You can also reply via email – be sure to leave the subject unchanged.

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Anonymous 2371

Normal user

12 Oct 2016, 20:03

Dear All,

I would like to know, if I can use Average Length stay (ALS) and Average Weight Gain in the management of SAM beneficiaries in OTP. At the moment, we do not have SFP program and according to the National CMAM protocol the beneficiaries are supposed to be in the program for a minimum of 8 weeks and not more than 12 weeks. Based on that, do I need again to monitor ALS? and Is it important for me to monitor Average Weight Gain as one of my performance indicators? and what is recommended Average Weight Gain in this kind of programme?

Thanks
EH

Paul Binns

Technical expert

14 Oct 2016, 10:49

Hi Anonymous,
Average weight gain and Average length of stay CAN be used as indicators of programme performance. The question would be whether they are useful to you or not. These calculations can diagnose that you have a problem but will not be useful to indicate what the problem is. Issues of poor compliance by beneficiaries, poor implementation of protocols by staff and poor case finding in the community, among other factors, can dramatically affect both of these performance measures.

A programme with a minimum stay of 8 weeks usually has an average LOS of about 62 days. Average weight gain (AWG) in OTP should be around 5g/kg/day or higher. AWG should be calculated separately for wasted cases and oedema cases.

The minimum stay of 8 weeks is an old discharge criterion which was introduced for MUAC programming many years ago. It was recommended that a child that had not recovered to the discharge criteria after 12 weeks in an outpatient programme despite home visits, should be transferred to inpatient for further assessment. No child should be discharged if they remain below the admission criteria.

The latest WHO recommendation is to use MUAC of 12.5cm as the discharge criterion for MUAC admissions. Weight for height admissions should be discharged by weight for height criteria.

An important point is that the length of recovery depends on the MUAC on admission and the compliance with the treatment regime. Ensuring effective early case finding and good attendance will reduce the length of stay. In a stable context ,the time taken to achieve a MUAC of > 12.5cm can take anywhere between 6 weeks for an 'early' admission and up to 15 weeks for a 'late' admission (e.g. MUAC < 10.5cm). The average LOS for this discharge criterion appears to be around 45 days.

I hope this helps

Anonymous 2371

Normal user

14 Oct 2016, 15:17

Thanks Paul

Emmanuel KALUFENYE NGENGELE

Normal user

14 Feb 2017, 18:16

An important point is that the length of recovery depends on the MUAC on admission and the compliance with the treatment regime. Ensuring effective early case finding and good attendance will reduce the length of stay. In a stable context ,the time taken to achieve a MUAC of > 12.5cm can take anywhere between 6 weeks for an 'early' admission and up to 15 weeks for a 'late' admission (e.g. MUAC < 10.5cm). The average LOS for this discharge criterion appears to be around 40 days as in RDC.

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