Evaluation of the Management of Severe Malnutrition in Two Hospitals in Namibia

Abstract

As in most developing countries, Namibia has a prevalence of malnutrition that is still unacceptably high and the case fatality rates for severe malnutrition are expected to be correspondingly high. This is not documented as not many studies have been done in the country around the subject. This mini-thesis evaluates the management of severe malnutrition in one central hospital and one district hospital in Namibia. A cross sectional, quantitative study was undertaken in the two hospitals. A total of 154 records of all children below the age of five who were admitted for severe malnutrition over a period of thirteen months were reviewed to obtain information about recorded practices in the management of severe malnutrition. A doctor and sister in-charge from each paediatric ward were interviewed to obtain information about current practices in the management of severe malnutrition. Structured observation of available resources needed for the management of severe malnutrition was carried out. The data was analysed using Microsoft Excel computer program. The case fatality rates for severe malnutrition were calculated, and the available resources and reported practices of paediatric staff were compared with WHO guidelines for the management of severe malnutrition. The case fatality rates at Katutura hospital and St. Mary's hospitals were l4Yo and 8% respectively. In Katutura hospital and St. Mary's hospital, staff correctly recorded 58% and 40% of the recommended practices respectively. Both hospitals had close to 90% of the resources required for the treatment of severe malnutrition. The findings of this study indicate that the case fatality rates for severe malnutrition in the two hospitals are not very high but can be improved. The treatment practices were not in line with the WHO guidelines. The findings and recommendations will be communicated to the relevant stakeholders for consideration and actions.