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Length of stay in OTP

This question was posted the Management of wasting/acute malnutrition forum area and has 2 replies.

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Anonymous 422

Normal user

1 Dec 2010, 17:05

According to CTC guidelines and SPHERE standards the internationally accepted length of stay in OTP is about 56 days. A program that was mainly admitting children to OTP using MUAC had length of stay about 63 day and an evaluation revealed there were some children who had stayed in program than needed. However,the program has began admision of children to OTP using weight for height Zscores and MUAC in line in MOH guideline. The MOH guideline only emphasize that children admitted on MUAC should be in program for minimum of 8 weeks which in essence is about 56days. However,the guidelines do not give an estimate of the expected length of stay for children admitted to OTP using WHZ . So my concern,is there significant difference in length of stay of children admitted on WHZ to those admitted using MUAC? are there internationally accepted standard length of stay for children admitted using WHZ?

Rogers Wanyama

Emergency Nutrition Specialist

Normal user

2 Dec 2010, 09:25

Hi Daniel According to the Guidelines for Selective Feeding the Management of Malnutrition in Emergencies by UNHCR/WFP in collaboration of the United Nations Standing Committee on Nutrition and the World Health Organization, May 2009, indicate that, the standard average length stay for recovered children in therapeutic Programme be < 60 days for children in TFP (Inpatient and outpatient care combined) and 3-4 Weeks for Inpatient care till full recovery. Note: The fact sheet on the implementation of 2006 WHO Child Growth Standards for emergency nutrition programmes for children aged 6-59 months released by IASC Global Nutrition Cluster, and Standing Committee on Nutrition (SCN) Task Force on Assessment, Monitoring, and Evaluation, March 2009, recommended that Percentage weight gain of 15% was as a criterion for discharge to be used for all children admitted to therapeutic feeding programmes, either on weight-for-height or on MUAC. It especially recommended for children admitted with MUAC as there is no reliable threshold established for minimum MUAC for discharge. I tend to think if using the same criterion for discharge; one will be able to calculate LOS and make a comparison ,unlike using MLOS for MUAC admissions and a different one for WHZ admissions. Thanks

Regine Kopplow

Sen. Adv. FNS Concern Worldwide

Normal user

2 Dec 2010, 09:55

CMAM data from Bardiya Nepal (2009) shows that there was no significant difference in length of stay between children admitted by MUAC <115mm or WHZ <-3. MUAC admissions, LOS=39.3 days (n=279) WHZ admissions, LOS=37.4 days (n=255) Discharge criteria was 15% weight gain AND MUAC>=115mm AND WHZ>=-3 AND no oedema, no minimum length of stay in programme required. It has to be noted that some children met MUAC as well as WHZ admission criteria when admitted. Oedema cases were excluded from this analysis.

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