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What is the average LOS of a child submitted into OTP programme?

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

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Anonymous 651

Nutrition trainee

Normal user

2 Dec 2011, 12:03

Hi there, I'm writing a report on the Length of Stay (LOS) for children admitted into OTP programmes. Does anyone know of any reference data which gives an average recommendation for how long a child with SAM is expected to remain in the programme? Are there recommendations according to initial weight at admission? Many thanks for you help in advance

Anonymous 635


Normal user

3 Dec 2011, 10:40

Dear The minimum length of stay in for severe malnourished children admitted in OTP program is 2 months and Maximum 4 months. you can get assistance and used FANTA as a reference

Mark Myatt

Frequent user

3 Dec 2011, 15:56

The simple answer is we keep them in until they are cured or meet a "discharge as not responding" criteria. The longer answer is that median LOS depends upon the degree of severity of wasting / oedema / concurrent infection. If the bulk of admissions are at or just below the admission threshold then median LOS will be short. Last year I reviewed a CMAM program admitting on MUAC < 110 mm with over 75% of admissions above 108 mm. The median LOS was a little over 30 days. A few months ago I reviewed a CMAM program admitting on MUAC < 115 mm with over 50% of admissions above 112 mm. The median LOS was 56 days. In this latter program, systemic antimicrobials were absent and there was a lot of intra-household sharing of RUTF. This points to the other factor that strongly affects LOS ... compliance. Compliance has two faces. The program can fail to comply (e.g. RUTF stock-outs, lack of essential drugs, failure to provide a protection ration, &c.). The carer / beneficiary can fail to comply (e.g. sharing of RUTF). Both failures in compliance will tend to lead to longer LOS. Note that there is a virtuous circle here. Any child with a MUAC below the admission threshold but not in the program is a coverage failure. This means that programs that admit most cases at or just below the admission threshold are likely to be high coverage programs. Children in these programs get well quickly and very few die or need inpatient care. This results in a good reputation which encourages early treatment seeking which improves program outcomes which ... and so on. The opposite can also hold. Long LOS it typical of a low coverage program and low coverage programs tend to have poor outcomes which reduces coverage which ... and so on. LOS is a coverage proxy and is used as such in SQUEAC investigations (along with all sorts of other indicators). When I undertake SQUEAC investigations I see median LOS greater than about 8 weeks as a bad sign.

Rogers Wanyama

Nutrition Specialist

Normal user

4 Dec 2011, 07:18

Hi Rogers

Bheru Lal

Nutrition Programme Manager

Normal user

1 Apr 2012, 09:51

Hi everyone........ My question is that if child comes in discharge criteria in 3rd week then what should we do? or we should keep the child in program for two months? (LOS minimum-2months..........maximum -4 months)

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