Projects
Zambia
A community-based programme for the prevention of severe malnutrition in under 5 year old children in Lusaka, Zambia
This programme is a joint initiative between the Lusaka University Teaching Hospital (UTH) Department of Paediatrics, the School of Medicine, Lusaka and Childhealth Advocacy International (CAI).
Dr. Peter Wilkinson, a retired paediatrician, is the CAI Honorary Country Director and has now made numerous visits to Lusaka, to further progress the programme.
In Zambia, 168 out of every 1000 children die before their fifth birthday. The major causes of death are malaria, diarrhoea, pneumonia and measles, which are mostly preventable.
Malnutrition underlies 54% of these deaths.
Nearly half (47%) of under 5 year old children in Zambia are malnourished, sufficiently severe to cause stunting of growth.
In hospital, the mortality for children with severe malnutrition can be up to 40%. Poverty, late arrival of patients, underlying infections such as pneumonia, diarrhoea, TB and HIV/AIDS could have contributed to this high mortality. 58% of children on the malnutrition ward were found to be HIV positive.
30% of admissions are re-admissions, indicating that children just return home to the same adverse conditions.
When children are discharged home from hospital, only 50% return for essential follow-up.
Because of these worrying statistics, a community- based programme was planned - the aim being to prevent the development of severe malnutrition, by earlier intervention in the community, before the malnutrition becomes severe, with its associated high mortality.
The programme has been running successfully since December 2002. Four clinics have now been established in the most deprived districts in Lusaka.
Close links have been made with the Lusaka District Health Management Board (LDHMB).
It is a nurse-led service (paediatric nurses from UTH), with strong support from the Department of Paediatrics, UTH. The children receive a medical assessment, essential medicines and multivitamins and high energy protein feeds. The families receive detailed practical nutritional advice.
- The programme is successful in reducing the need for hospital admission.
- 80% of children on the programme attain their target weight within 6 weeks.
- There is earlier identification of children who are HIV positive.
The aim now is for sustainability of the programme by continuing cooperation with other NGO’s and with the LDHMB.
