guidelines for the integrated management of severe acute malnutrition

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ACF-In Guidelines for the integrated management of SAM Annexes 142 Annexe 2: Out Patient Therapeutic Care Programme Draft plan Out Patient Therapeutic Care Programme Draft plan 1. Introduction This is a draft plan for an OTP programme. No solid plan can be given, as it depends on many different things, how your centre will be positioned and functioning. There can be different locations for OTP as well: in an existing building (like a health centre), an annex to an existing building, or a completely new construction. Or just under the village tree. The type of construction you make depends on if it is an emergency response or working within the MoH structures: - the place available - the number of beneficiaries expected - the time the programme is expected to be in place - the time available to set up the construction - the budget available - … 2. Different spaces needed - A fence or way of “separating” the OTP from the surrounding area, especially if the OTP is in a camp, a densely populated area and/or is there is a high number of beneficiaries and a high pressure to get enrolled in the programme - Gates: preferably 2: 1 entry and 1 exit (especially if high number of beneficiaries expected), that can be closed and locked. If a fence is needed - Waiting area: an area where people wait to be measured and registered. It must be sufficiently big, shady so people don’t wait in the sun, and have mats or benches so people can sit. It can be just a roof - Health education room: a room where small groups of people are taken for the health education session and RUTF appetite test is conducted. It must also be shady, airy and have mats or benches. In small programmes, or where there is not enough space, the waiting area and health education room can be the same. Where a lot of beneficiaries are expected, a separate room is preferred - Measuring room: where weight, height etc. are taken. It should be shady, airy, fenced of (or have a wall) and contain a bench or mats For the height board and adult scale, a concrete surface is needed to put the material on. There must be a space where the Salter scale can be hung. If adolescents and adults are admitted, a fenced of corner might be necessary to weigh women & girls without too many clothes (eg. Chador)
ACF-In Guidelines for the integrated management of SAM Annexes 143 - Registration room: a space, right after the measurements where the register(s) work. It needs space for one table, and some chairs or benches for the beneficiaries - Nurse: a space where the nurse can do the consultation and distribute the drugs. It must be big enough for one table and benches for the beneficiaries. - Food distributor: a space where the rations are distributed. Big enough to put one table and a drum(s) or bag(s) of rations - Stock: if food is left in the centre, an appropriate storeroom is needed, large enough, with protection from rodents and insects (pallets, walls, roof…) from rain and sun, and you must be able to close it and lock everything up to avoid theft - Latrines: A number of latrines, accordingly to the number of beneficiaries and staff expected to be present, must be available - Hand washing and drinking points: a water source must be available to make sure there is enough water to drink for beneficiaries waiting, and to fill the hand washing points (min. one at the nurse, one at the premix room, one at the exit of latrines). If there is an epidemic of cholera or other diarrhoeal of infectious diseases, more hygiene measures must be taken (pediluves, spraying…) The different spaces can be made up of one big building, with low fences or other to separate the different locations, or of different buildings. All the spaces, and the doors must in such a logic that beneficiaries can go from one space to another (as above), in a logical “flow”. This means, come in on one side, get out on the other, from there enter immediately in the next room etc. If people have to turn back where they came from, walk to the other side of the centre for the next room… beneficiaries get lost (eg they arrive at the food distributor without being measured), it is easier to cheat (eg. Return twice) and above all, it creates a big chaos. Drinking water must be available and presented to the beneficiaries waiting, so cups must be available, as well as a space to clean them.
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Page 181 and 182: Cover photography: © ACF, Anne-Dom
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guidelines for the integrated management of severe acute malnutrition

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