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OTP - Reduced frequency of visits in insecure areas or non-functioning health system

This question was posted the Management of wasting/acute malnutrition forum area and has 4 replies.

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Anonymous 32524

Normal user

28 Aug 2019, 21:32

Standard outpatient treatment of uncomplicated SAM requires children to attend health/ nutrition centres weekly for follow-up visits and RUTF.

In insecure areas and/ or areas where health system is not functioning or NGOs have limited presence, weekly attendance at centres is not always feasible for caregivers and their children.

In such contexts is there experience of follow-up outpatient visits for uncomplicated SAM cases taking place less frequently (e.g. fortnightly or even monthly), with children receiving enough RUTF to cover fortnightly or monthly needs between visits ? If so, is there any documentation available on OTP performance indicators or sharing of RUTF ? 


Mark Myatt

Frequent user

30 Aug 2019, 16:24

Some of the "single program" method (i.e. program treating both MAM and SAM) often use reduced intensity programming (e.g. lower quantities of RUTF and / or fortnightly contact) for MAM or uncomplicated SAM cases and achieve acceptable outcomes. It is quite common, when security is poor or travel distances are large to reduce contact frequency in OTP in order to keep cost to households acceptable. These programs also achieve acceptable outcomes. I think monthly contact may be too infrequent to monitor response to treatment properly.

Mark Myatt

Frequent user

30 Aug 2019, 16:45

You may find this Field Exchange issue on "continuum of care" of relevance here.

André Briend

Frequent user

30 Aug 2019, 16:57

This article is also relevant to this discussion:

Feasibility of engaging caregivers in at-home surveillance of children with uncomplicated severe acute malnutrition.

Isanaka S, Berthé F, Nackers F, Tang K, Hanson KE, Grais RF.

Matern Child Nutr. 2019 Jul 23:e12876. doi: 10.1111/mcn.12876.


Forum Moderator, ENN

Forum moderator

2 Sep 2019, 13:20

There was a problem with the link in the last message. Please find the article here: and now corrected in the previous post. 

If you have any problem posting a response, please contact the moderator at

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