Why do some families become defaulters in a hospital based nutrition rehabilitation follow-up programme

Abstract

Since 1989, a nutrition rehabilitation follow-up (NFU) service is being offered in the Dhaka hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh. Parents bring their children for treatment of diarrhoea and those with additional diagnosis of moderate to severe protein energy malnutrition (PEM) are referred to NFU. Families with severely undernourished children are encouraged to attend NFU. Some of them do not come back to NFU after the first or subsequent visits and are considered as 'defaulters'. This paper focuses on the reasons why some families become defaulters. Thirty-two defaulter families were matched with an equal number of non-defaulter families for age and gender of the child and follow-up visit number. All families were interviewed. Children from both groups had similar nutritional, socio-economic status and parental education level. The main reason stated by defaulter mothers for not coming to NFU was 'follow-up was not needed since the child was okay'. The main reason for coming to NFU stated by non-defaulter mothers was for 'the child's improvement', indicating that parental perception of the child's nutritional status differ in the two groups. A greater proportion (75%) of defaulter mothers as compared to non-defaulter mothers (41%) came to NFU accompanied by another adult. It was not possible to identify potential defaulters. Thus all families accepting NFU must be given equal attention. The poor nutritional status of the child and associated risks must be explained to the mother and other family members. The benefits of NFU to the child and family must be stressed.(ABSTRACT TRUNCATED AT 250 WORDS)