Student Dissertation

Agency : Nutrition Rehabilitation Centre; Performance Assessment; Managerial Issues; Performance Assessment

Objective : 1. To analyze the output indicators of Nutritional Rehabilitation Centers to assess its performance. 2. To explore various managerial issues and challenges hindering the effective implementation of the program at NRC.

Background : Nutrition Rehabilitation Centre (NRC) is a unit in a health facility where children with Severe Acute Malnutrition (SAM) are admitted and managed. Children are admitted as per the defined admission criteria and provided with medical and nutritional therapeutic care. Once discharged from the NRC, the child continues to be in the Nutrition Rehabilitation program till she/he attains the defined discharge criteria from the program (described in technical guidelines). In addition to curative care, special focus is given on timely, adequate and appropriate feeding for children; and on improving the skills of mothers and caregivers on complete age appropriate caring and feeding practices. In addition, efforts are made to build the capacity of others/caregivers through counselling and support to identify the nutrition and health problems in their child.

Methodology : It is a cross-sectional descriptive study carried out over a period of three months starting Feb’17 A mixed method research design was used which included mixing of qualitative and quantitative data and methods in Congruence with the research question asked. Quantitative – Performance Assessment using key output indicators Qualitative – Conducting in-depth interviews to explore various managerial issues and challenges hindering the effective implementation of the program at NRC.

Findings : Almost half of the respondents did not fulfill the criteria for MUAC>11.5 cm on Admission. The recovery rate was very poor as it was far below the standard criteria i.e. 9.45% at Discharge and 20.54% at Follow-up. The Average weight gain was 3.2g/kg/day and the bed occupancy rate was 30%. The defaulter and relapse rates were 10% and 1% respectively. Non-Respondent rate was poor as one-third of the respondents failed to respond to the treatment i.e. 34.74%.

Recommendations :Conclusion: There is no doubt to the fact that Nutrition Rehabilitation Centre can play a vital role in reducing the burden of morbidity and mortality associated with Malnutrition on the community, provided active screening and prompt treatment is done well. Thus, in conclusion, we can say that, with consolidated efforts from all the key stakeholders at various levels of healthcare system, Nutrition Rehabilitation Centres can be established as an effective intervention to curb the menace of Malnutrition and its associated complications and render good health and well-being to all its beneficiaries.