EFFECTIVE MANAGEMENT OF SEVERE ACUTE MALNUTRITION IN CHILDREN INSIGHTS FROM SWAT DISTRICT, PAKISTAN

Abstract

Background: Severe acute malnutrition (SAM) remains a major contributor to childhood morbidity and mortality, particularly in low-resource settings. In Pakistan, undernutrition affects millions of children under five, posing significant public health challenges. SAM, often complicated by infections such as acute respiratory infections (ARI), diarrhea, and fever, requires a coordinated clinical and nutritional response. Timely identification, effective treatment, and caregiver education are key to improving outcomes and reducing child mortality rates in such vulnerable populations.

Objective: To assess the management and outcomes of severe acute malnutrition among children aged 6–59 months in the Swat district of Khyber Pakhtunkhwa, with a focus on admission trends, disease comorbidities, community nutrition education, and therapeutic commodity utilization.

Methods: A descriptive cross-sectional study was conducted at the PAEDS B ward in Swat. A sample of 422 children aged 6–59 months was selected using population-based sampling with a 95% confidence level and 5% margin of error. Data were collected through clinical records, MIYCN session attendance logs, and inventory registers. Information included age- and sex-wise admissions, discharge outcomes, disease diagnoses, nutrition education sessions, and quantities of therapeutic foods (F-75, F-100, Resomal, RUTF). Descriptive statistics were applied for analysis, and ethical clearance was obtained from the relevant committee.

Results: Among children <6 months, recovery rates were 93.8% and 94.1% in two sub-groups, with one death in each. For the 6–23 months age group, recovery was 97.8% and 100%, with only one death overall. All children aged 24–59 months fully recovered. ARI (n=38), diarrhea (n=38), and edema (n=31) were the most reported conditions. MIYCN sessions engaged 14 pregnant mothers, 7 lactating mothers, and 12 grandmothers. Of the 21,600 RUTF sachets received, none were used. F-75 (n=264) and F-100 (n=48) were adequately consumed without stock-outs.

Conclusion: SAM management in Swat has shown commendable outcomes, especially in older children. Continued integration of disease treatment, enhanced caregiver education, and improved resource utilization are essential for sustainable malnutrition control.