Nutrition rehabilitation: an approach to the management and prevention of childhood malnutrition

Abstract

Manifest childhood malnutrition is a serious and common problem in most of the Third World, often complicated by other childhood diseases. Most research and medical attention have been given to children with the severest degrees of protein-energy malnutrition (PEM) with medical complications. Such children have always received high priority for admission to scarce paediatric hospital beds. This medical assumption, that hospital admission is necessary and appropriate for the management of PEM, has been clearly reviewed and challenged by Cook (1971). He quotes high in-patient mortality in most published hospital series and poor progress after discharge where this has been infrequently studied. He concludes that, ‘In most parts of the world for many malnourished children discharged from hospital, the path of their progress leads but to the grave’.