Reducing the Frequency of Follow up and Task Sharing in the Treatment of Uncomplicated Severe Acute Malnutrition
Condition: Severe Acute Malnutrition
MeSH terms: Malnutrition; Severe Acute Malnutrition
Study type: Interventional

Summary: 
      This study will be conducted as a stratified cluster randomized trial. The unit of
      randomization will be the outpatient therapeutic feeding center. The 10 health centers will
      be stratified by size, and centers within a stratum will be randomized in a 1:1 ratio to one
      of two schedules of treatment: (1) standard weekly visits or (2) monthly visits with support
      for home-based surveillance.
    

Detailed description: 
      This study will be conducted as a stratified cluster randomized trial of a monthly schedule
      of follow up in the treatment of uncomplicated SAM among children aged 6 to 59 months. The
      unit of randomization will be the outpatient therapeutic feeding center. The 10 health
      centers supported by International Medical Corps UK (IMC-UK) will be stratified by size (±
      1000 admissions per site per year), and centers within a stratum will be randomized in a 1:1
      ratio to one of two schedules of treatment: (1) standard weekly visits or (2) monthly visits
      with support for home-based surveillance.

      Distribution of the therapeutic feeding rations, as well as medical and anthropometric
      surveillance, will take place on a weekly or monthly basis until discharge according to the
      random assignment of the site. Caregivers in the monthly visit group will receive additional
      instruction at admission regarding home-based MUAC measurement and clinical surveillance.

      Regardless of intervention assignment, all children with uncomplicated SAM will receive
      standard medical care on admission as per national guidelines, and a home visit 2 months
      following discharge from the nutritional program. Additional data collection, including
      coverage assessment and economic costing analysis will be used to address the secondary
      objectives related to the evaluation of coverage and cost-effectiveness, respectively.
    

Intervention name(s): Standard weekly visits; Monthly visits
Intervention type(s): Other; Other
Intervention description(s): Distribution of the therapeutic feeding rations, as well as medical and anthropometric surveillance, will take place on a weekly basis at the outpatient therapeutic feeding center according to the random assignment of the site, until discharge; Distribution of the therapeutic feeding rations, as well as medical and anthropometric surveillance, will take place on a monthly basis at the outpatient therapeutic feeding center according to the random assignment of the site, until discharge
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Standard weekly visits at the outpatient therapeutic feeding center until discharge
Monthly visits at the outpatient therapeutic feeding center with caregiver support for home-based surveillance, with visits scheduled at weeks 4, 8, 10 and 12 until discharge.
Masking: None (Open Label)
Primary purpose: Other