Management of malnutrition and cost implications: the case study of maternal and child health hospital, Kumasi

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There is a high prevalence of malnutrition in developing countries which is worsen by socio-economic factors and infections. In 1998, Ashanti Region registered 11 % as malnutrition rate for age group 0-23 months compared to national malnutrition in the region are of 5 to 6%. Most cases of malnutrition in the region are referred and treated at Maternal and Child Health Hospital in Kumasi. Not much attention is being given to the cost implication in managing malnutrition cases. The hospital is uncertain of how much it cost to treat a malnourished child. The study therefore sought to assess the financial cost of managing malnourished children at Maternal and Child Health Hospital in Kumasi excluding OPD costs, out of hospital costs and other opportunity costs. The study was cross sectional in nature with a sample size of 50 and facilitated by review of primary and secondary data, structured interview guide. The key findings were that malnourished cases occurred mostly within the age group of 12-23 months. Within that age group, the female malnourished cases were higher than the males in 1998-1999. Mortality was higher among females than males. In 2000, the trend of malnutrition ca e and mortality skewed towards males. One major key finding was the use of Intravenous fluids inappropriate for managing moderate to severe malnutrition. Most malnutrition cases came from Tafo and the Zongo areas specifically associated with Ayigya, Alabar and Moshi Zongo. One of the contributory factors to the above was due to poor health education mostly in the area of cause and prevention of malnutrition. Only one feeding protocol was used for various types of malnutrition with inadequate staff. The hospital through the internally generated fund was funding 50% of the total cost of treating malnutrition cases. The average cost of managing malnutrition child was ¢766,462.00 per period of 5 weeks. The study indicated that, there was a need to train staff especially in the areas of causes and prevention of malnutrition. There should be effective health education at the Zongo areas. There is the need to use different feUeding p m (.Urotocols based on type and cause of malnutrition. The key findings could be addressed if there was intensification of health education of the Zongo area of Tafo with respect to the cause and prevention of malnutrition. In-service training of health staff on management of malnutrition should emphasise the need to use different treatment and feeding protocol to reduce mortality and mortality associated with the different type of malnutrition. There is the need to do appropriate budgeting with government funds, in combination with relevant feeding methods to reduce malnutrition line with the objectives of the MTHS.
A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of in Health Services Planning and Management, 2001