Management Of Severe Malnutrition

The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.

This book provides clear, concise and practical guidelines for treating severely malnourished children successfully, taking into account the limited resources of many hospitals and health units in developing countries, and consistent with other WHO publications. It aims to help improve the quality of inpatient care and so prevent unnecessary deaths, and hospitals which have used these guidelines have reported substantial reductions in mortality rates.

This manual provides expert practical guidelines for the management of severely malnourished children. Addressed to doctors and other senior health workers, the manual explains exactly what must be done to save lives, achieve successful management and rehabilitation, prevent relapse, and thus give these children the greatest chance of full recovery. Throughout, the importance of treating severe malnutrition as both a medical and a social disorder is repeatedly emphasized. As successful management does not require sophisticated facilities and equipment or highly qualified personnel, the manual also performs a persuasive function, encouraging health professionals to do all they can to save these children and meet their great need for care and affection. Recommended procedures draw on extensive practical experience as well as several recent therapeutic advances. These include improved solutions of oral rehydration salts for the treatment of dehydration, better understanding of the role of micronutrients in dietary management, and growing evidence that physical and psychological stimulation can help prevent long-term consequences of impaired growth and psychological development. Noting that the physiology of malnourished children is seriously abnormal, the manual gives particular attention to aspects of management - whether involving the interpretation of symptoms or the use of specific interventions - that differ considerably from standard procedures for well-nourished children. Details range from the reasons why IV infusion easily causes overhydration and heart failure, through a list of treatments that have no value and should never be used, to the simple reminder that underarm temperature is not a reliable guide to body temperature in a malnourished child during rewarming. Further practical guidance is provided in eight appendices, which use numerous tables, charts, sample recording forms, instructions for preparing feeds, and examples of easily constructed toys to help ensure that management is thorough, safe, and in line with the latest knowledge.

The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

Many malnourished children still die unnecessarily due to inadequate inpatient care. This book describes the ten treatment steps needed to manage these children successfully. It is based on guidelines developed by the World Health Organization and on training modules prepared for nurses in Africa. It takes into account resources in many hospitals and health centres, and the fact that many malnourished chidlren are also HIV+. The book is intended for nurses and other health workers who care for severely malnourished children in developing countries. It also should be useful to their trainers and supervisors.

This manual is for use by doctors, senior nurses and other senior health workers who are responsible for the care of young children at the first referral level in developing countries. It presents up-to-date expert clinical guidelines for both inpatient and outpatient care in small hospitals where basic laboratory facilities and essential drugs and inexpensive medicines are available. The manual focuses on the inpatient management of the major causes of childhood mortality, such as pneumonia, diarrhoea, severe malnutrition,, malaria, meningitis, measles, and related conditions. Descriptions of expensive treatment options are deliberately omitted from the manual.

This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, including in the context of HIV. The guideline will help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions for severely malnourished children. It will also support Member States in their efforts to achieve global targets on the maternal, infant and young child nutrition comprehensive implementation plan, especially global target 1, which entails achieving 40% reduction by 2025 of the global number of children under 5 years who are stunted and global target 6 that aims to reduce and maintain childhood wasting to less than 5%. The guideline is intended for a wide audience, including policy-makers, their expert advisers, and technical and programme staff in organizations involved in the design, implementation and scaling-up of nutrition actions for public health. The guideline will form the basis for a revised manual on the management of severe malnutrition for physicians and other senior health workers, and a training course on the management of severe malnutrition.