malnutrition and guide health workers to manage PEM
(malnutrition) properly; yet by august 2012, the book had
not reached the health workers in health centers which
are close to the Ministry of Health headquarters. This
affects service delivery, because if the heath workers had
the guidelines, they would try to follow them and look out
for malnutrition in every child they encounter.
Although RUFT is the recommended treatment for
severely malnourished children by the MOH Uganda and
WHO, only two of the visited health centers had RUFT in
their stock. This implies that those health centres without
RUFT will not be able to manage the children diagnosed
with SAM and will refer them to the centres that have
these facilities. Referral of these children may not save
their life since some caretakers may not have transport to
go to the referral site due to high poverty levels (UDHS,
2006), leading to increased mortality rate.
Observation from the study also found out that only 16
(7.1%) weight for age and 2 (0.89%) weight for height of
the children were calculated using standard charts, yet
the WHO (1999) management of severe malnutrition
manual considers them to be important in the diagnosis