Biochemical Assessment Tools for Monitoring Nutritional Rehabilitation in Severe Acute Malnutrition Programmes in Kebbi State

Nutritional rehabilitation of children with severe acute malnutrition requires structured biochemical monitoring to guide clinical decision-making and evaluate programme outcomes, yet the integration of biochemical assessment tools into therapeutic feeding programmes in Kebbi State remains inadequate. This study evaluates current biochemical monitoring practices in therapeutic feeding centres managing severe acute malnutrition in Kebbi State and develops recommendations for improved assessment protocols. A professional programme review was conducted across eight therapeutic feeding centres in Birnin Kebbi, Argungu, and Jega LGAs, combining structured facility assessment interviews with clinical officers and nutrition programme coordinators, review of three hundred patient medical records for documentation of biochemical parameters, and a gap analysis comparing current practice against WHO severe acute malnutrition management guidelines. Biochemical monitoring documentation was identified as a major programme weakness. Serum electrolytes were documented on admission in fewer than 40 percent of records, and no facility routinely monitored serum albumin or serum zinc during rehabilitation. Blood glucose monitoring was present in 68 percent of facilities but used inconsistently. Re-assessment biochemistry was documented in fewer than 25 percent of records across all facilities. The study develops a context-appropriate biochemical monitoring schedule specifying minimum biochemistry at admission, week two, and discharge, prioritized by evidence-based clinical importance and feasibility in limited-resource settings. Practical recommendations address sample collection logistics, result turnaround, and integration of biochemistry results into clinical nutrition care plans. Keywords: severe acute malnutrition, biochemical monitoring, therapeutic feeding, Kebbi State, nutritional rehabilitation.