Background: In India, approximately 7.5 percent of children under five experience severe wasting (low weight-for-height), a measure of severe acute malnutrition (SAM). The WHO and UNICEF recommended the provision of ready-to-use therapeutic foods (RUTF) in community-based programs to treat uncomplicated severe acute malnutrition. In our first objective, we assess the process outcomes of community-based screening for severe wasting and provision of RUTF through community health workers. Second, we compare recovery outcomes of severely wasted children who reportedly consumed MNT with those who reported consuming none to insubstantial quantities of MNT.

Methods: The study follows a case series without a control methodology similar to other program reviews. To compare characteristics of children across treatment groups, we use Pearson’s chi-squared tests and to examine recovery outcomes, 8-week anthropometric status is calculated.

Results: Among the 543 children followed up, out of the 338 (62%) who went to a health camp or the NRRC, 174 were confirmed as severely wasted by a doctor, passed an appetite test for MNT, and given a prescription for MNT. Among those who consumed MNT, nearly forty percent of the < 28 cups children remained severely wasted at the time of their anthropometric measurement closest to the 8-week mark as compared with 19% of the 28+ cups children. While a similar percentage of children (about one-quarter) across both groups had fully recovered to no longer being wasted, more children in the 28+ consumption group had shown improvement to moderate wasting (53 percent moderately wasted as compared to 36 percent in the < 28 cups group).

Conclusion: Implementation strategies to improve diagnosis of severe wasting, provision of RUTF, and compliance with RUTF dosages are required. However, the costs and efforts involved in effective coverage of MNT in large-scale community-based programs may not justify the potentially small improvements in recovery.