Summary
Investigates Factors behind Prolonged Length of Stay in Outpatient Therapeutic Programs among Severely Malnourished Children at Kakuma Refugee Camp.
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Authors
Dorothy Kiptum
Lawrence Mugambi
Nyakoboke Oirere
Abstract
Severe Acute Malnutrition (SAM) remains a major cause of morbidity and mortality in humanitarian settings. Outpatient Therapeutic Programs (OTPs) are designed to treat uncomplicated SAM with an expected length of stay (LOS) of 6�8 weeks, yet reports from Kakuma Refugee Camp suggest longer durations. Understanding determinants of LOS can inform strategies to improve recovery and program efficiency. The objectives involve determining the proportion of children experiencing prolonged LOS in OTP (=9�12 weeks) and identifying socio- demographic, household, and healthcare access factors associated with LOS among children aged 6�59 months in Kakuma Refugee Camp, Kenya.
A descriptive cross-sectional study of 178 SAM cases (6�59 months) enrolled in OTPs was conducted using simple random sampling from program registries. Data were collected via caregiver questionnaires and program records on child characteristics, caregiver/household factors, and healthcare access/utilization. Analyses in SPSS v25 included descriptive statistics and Pearson correlations with significance at p < 0.05.
Of 178 children, 46.1% (n=82) achieved the expected LOS (6�8 weeks) and 53.9% (n=96) had prolonged LOS (9�12 weeks). Significant positive correlations with longer LOS included higher birth order (r=0.25, p=0.021), more under-five children in the household (r=0.22, p=0.011), receipt of aid/relief support (r=0.17, p=0.023), recent illness (r=0.186, p=0.043), participation in health education sessions (r=0.176, p=0.048), availability of medication/nutritional supplies (r=0.195, p=0.041), and satisfaction with healthcare services (r=0.204, p=0.031).
Protective (negative) correlations were observed for caregiver education (r=-0.17, p=0.025) and caregiver marital status (married) (r=-0.21, p=0.014). Over half of SAM cases in Kakuma experienced prolonged LOS in OTP. Later birth order, larger numbers of under-five children, aid dependence, recent illness, and certain service-use indicators were associated with longer stays, whereas caregiver education, marital stability, frequent clinic attendance, and consistent SAM treatment availability were associated with shorter stays.
Interventions to strengthen caregiver education and support, ensure uninterrupted SAM supplies, and promote regular attendance could reduce LOS and improve outcomes.