Outpatient Therapeutic Feeding Program Outcomes and Determinant in the Treatment of Severe Malnutrition in SOS Hospital in Heliwa District, Somalia

Hamdi Abdullahi Roble, Dr. Sophia Ngala (PhD), Dr. Dasel Wambua Mulwa Kaindi (PhD)

Abstract


Proper nutrition is vital for young children’s growth and health, especially those under two. Globally, 52 million children are affected by acute malnutrition, with common issues including anemia and vitamin A deficiency. In Somalia, drought and economic hardships have worsened malnutrition, affecting 1.2 million children under five over 231,000 of whom face life-threatening Severe Acute Malnutrition (SAM). This study assessed the prevalence, treatment outcomes, and key factors influencing SAM management. A descriptive cross-sectional study was conducted at SOS Hospital in Mogadishu, using systematic random sampling to select 343 children aged 6 to 59 months enrolled in the Outpatient Therapeutic Program (OTP) between December 2023 and April 2024. Structured questionnaires gathered information on demographics, maternal nutritional knowledge, cultural practices, dietary habits, food security, coping strategies, clinical history, medication adherence, and children’s nutritional status.  Maternal nutritional knowledge was moderate, 62% had medium knowledge, 34% low, and only 4% high. Key gaps included 13% unaware of when to stop breastfeeding, 55% unsure of when to start complementary feeding, and only 33% knowing sunlight is a source of vitamin D. Dietary diversity was low; only 31.3% of children met the required score and 35% consumed protein-rich foods. Food scarcity affected 74% of households, and 51% did not treat drinking water.  Malnutrition rates were high: 48.2% experienced acute malnutrition (more common in boys: 54.3% vs. 45.7%), 61.8% were stunted, 83.8% underweight, and 2.5% overweight. Common illnesses included cough (15%), fever (14%), and diarrhea (11%), with 52% hospitalized. Significant factors associated with wasting included child illness (p=0.007), age under 6 months (p=0.000), and maternal age (p=0.003). Only 18.4% of children met the All5 score, with a mean (SD) of 4.2 (1.36). Consumption of legumes, pulses, nuts, and seeds was poor (31%). However, the mean (SD) NCD risk score was low at 0.88 (0.96), with 98.9% of children at minimal non-communicable disease risk. The study concludes that malnutrition is both acute and chronic, with low maternal knowledge, poor dietary diversity, and low All5 consumption. Despite high malnutrition, the risk of NCDs was minimal. The study recommends enhancing community service integration, staff training, and continuous monitoring of OTPs to improve treatment adherence and recovery outcomes at SOS Hospital in Mogadishu.

Keywords: Outpatient, Therapeutic Feeding Program Outcomes, Treatment of Severe Malnutrition


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References


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