Management of Severe Acute Malnutrition Using the Community-Based Therapeutic Care Model in Katsina State, North West Nigeria

Severe acute malnutrition (SAM) carries high mortality risk among children under five, yet the majority of SAM cases are manageable at community level through outpatient therapeutic care (OTC). This study assesses the operational effectiveness of the community-based therapeutic care (CBTC) model for managing SAM in Katsina State, North West Nigeria. A retrospective programme evaluation was conducted using routine data from 18 CBTC sites across six local government areas over a 24-month programme cycle from January 2022 to December 2023. Indicators assessed included admission rates, recovery rates, default rates, mortality rates, and average length of stay, benchmarked against SPHERE standards. A total of 2,148 SAM children were admitted, of whom 78.4% achieved recovery, 11.6% defaulted, 4.9% were transferred to inpatient care, and 5.1% died. Recovery rates fell below the 75% SPHERE target in four of the six districts. Common drivers of default included transportation challenges, caregiver perception of recovery before programme completion, and stock-outs of ready-to-use therapeutic food (RUTF). Community mobilisation through village health workers significantly improved retention rates in high-performing sites. The study recommends enhanced caregiver education on programme adherence, strengthened RUTF supply chains, and investment in community-level follow-up mechanisms to improve CBTC programme outcomes in Katsina State. Keywords: severe acute malnutrition, CBTC, outpatient therapy, Katsina State, North West Nigeria.