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Outpatient Rehabilitation of Severe Protein Energy Malnutrition (PEM)

Protein energy malnutrition (PEM) is still a major public health problem in Indonesia. Approximately 25 to 30 per cent of children have mild or moderate PEM and 1 to 3 per cent are severe [11] . The mortality rate from severe PEM without hospitalization is about 50 per cent, but with hospital treatment it can be reduced by 10 to 30 per cent depending on the severity of the case and quality of the hospital facilities [2]. Because of the limitations imposed by socio-economic conditions and the inadequacy of hospital services, children with severe PEM are usually not hospitalized. This article reports on an unconventional method of treating children with severe PEM as outpatients at a nutrition clinic, emphasizing nutrition guidelines and education for the children’s mothers.