Effectiveness of a Standardised Educational Package for Mothers of Children with Severe Acute Malnutrition: A Hospital-based Randomised Controlled Trial

Abstract

Introduction: Malnutrition is a major public health problem, especially in Low- and Middle-Income Countries (LMICs), contributing significantly to under-five mortality. New strategies are needed to enhance outcomes for childhood malnutrition. Aim: To evaluate the impact of an educational package on mothers of children hospitalised with Severe Acute Malnutrition (SAM). Materials and Methods: This was a hospital-based randomised controlled trial conducted in the Department of Paediatrics at Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. Only children hospitalised between 6 months and 59 months of age with SAM were included and randomised into an Intervention group and a Control group. In the intervention group, verbal, pictorial, and demonstration techniques were used to educate the mothers. Anthropometric measurements of malnourished children and maternal knowledge scores were compared at baseline, 15 days, and two months postdischarge. Frequency and percentage were calculated for qualitative data analysis, while mean values with standard deviations were calculated for quantitative data. Independent t-tests and paired t-tests were applied, and paired t-tests were used for within-group comparisons at different time points. Data was entered into Microsoft Excel software, and analysis was performed using Statistical Package for Social Sciences (SPSS) version 22.0. Results: The mean age of children was 1.4±0.9 years, with the majority below two years of age (86.4%). The male-to-female ratio was 1.04 (n=154 versus n=148). Most subjects belonged to lower or upper-lower socio-economic classes (75%). Mothers were commonly educated up to the primary school level (48%). Both study groups had similar socio-demographic profiles. There was a significant weight gain (p-value <0.01) and height gain (p-value <0.01) in the intervention group at the end of the follow-up period. Maternal knowledge gain in the intervention group was also significantly higher than in the control group (p-value <0.01). Conclusion: This study supports maternal educational strategies as a low-cost intervention to address early childhood malnutrition in resource-limited settings. Further research is needed to standardise the intervention and assess long-term impact.