Process evaluation of the outpatient therapeutic program for sever acute malnourished children aged 6-59 months in Dehana district, Waghmera zone, northern Ethiopia

Abstract

Abstract Background: Acute malnutrition is one of the major global health problems that contribute to12 million child mortality in the world and accounting for 57% of child mortality in Ethiopia. To curb the challenges and limitations of managing malnourished cases in the therapeutic feeding centers, an outpatient therapeutic program had been introduced. Objective: To evaluate the process of an outpatient therapeutic program for severe acute malnourished children aged 6-59 months in Dehana district, northern Ethiopia, 2020. Methods: A facility-based cross-sectional mixed evaluation was employed from FebruaryMarch 2020. Availability, compliance, and acceptability dimensions with a total of 34 indicators were used to evaluate the program. A total of 384 records, 422 caregiver interviews, 9 key informant interviews and 63 observations were included. Quantitative data were entered into Epi data and exported to SPSS 25. Multivariable logistic regression was used to identify predictor variables of acceptability. Finally, Adjusted Odds Ratio with 95% confidence interval and a pvalue of <0.05 was used to declare statistically significant variables with acceptability. Results: the overall process of outpatient treatment program was 78% to which availability, compliance, and acceptability contributed 87, 75, and 77%, respectively. Trained health care providers, RUTF, Mebendazole, and ORS were available in all health posts whereas vit.A and folic acid were stocked out in some health posts. The health care providers complained that interruption of supplies, work overload, and improper usage of RUTF by caregivers were problems to deliver the program appropriately. Residence Conclusion: the process of outpatient treatment program was fair and needs some improvement. The availability of resources was good, the compliance of health care providers to the standards, and the acceptability of program services was fair based on the pre-setting judgment parameter. Therefore, regional health bureau, zonal health department, district health office, NGOs, and health care providers shall be coordinated and worked for the program improvement. Keywords: Evaluation, availability, compliance, acceptability, OTP, Ethiopia