Early Detection and Referral of Children with Malnutrition

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Detection and Referral of Children with Acute Malnutrition

Setting up a referral system for Acute Malnutrition

1. Underlying principles:

Child acute malnutrition can be identified in primary health centers and in the communities before the onset of complications. Workers at facility and community level can be trained on the use of Mid-Upper Arm Circumference (MUAC) tape and on recognition of bilateral pitting oedema.

Whenever referred, it is crucial that caregivers understand the life saving importance of going immediately to the recommended facility where their children will be fully assessed to determine the type of care they should receive.

Early detection and referral, coupled with decentralized treatment makes it possible to start management of acute malnutrition before the onset of life-threatening complications.

Detecting and referring children with acute malnutrition are the foundation for integrated management of malnutrition at facility and community level.

2. Division of roles for malnutrition screening and assessment:

Community:

• Taking Mid-Upper Arm Circumference (MUAC).
   
• Checking presence of oedema.
   
• Referring children with acute malnutrition to sites with treatment services.

All functional Health Centers:

• Taking Mid-Upper Arm Circumference (MUAC).
   
• Checking presence of oedema.
   
• Referring children with acute malnutrition to sites with treatment services.

Health Centers with treatment services (therapeutic and supplementary feeding programs):

• Taking anthropometric measurements (W/H and W/L, presence of oedema and Mid-Upper Arm Circumference (MUAC))
   
• Diagnosis and decision on type of treatment.

3. Referral forms for children with acute malnutrition

It is crucial that trained workers at facility and community level locate the nearest facilities to refer cases with Severe/Moderate Malnutrition.

Referral should be done in writing using the Format below wherever possible. Caregivers must take the referral form with them to the recommended facility and present it on arrival.

A referral letter/form must contain the following essential elements:

02 January, 2009