Table 3 Implementation of WHO guidelines*.

10 Routine treatment steps		Sipetu	Mary Theresa
Treat/prevent hypoglycaemia (prioritise for immediate admission; feed every 3 h day and night; start straightaway)
Mean time in outpatient department before admission (C+R) (hours)		4.9	3.9
% fed within 1 h of admission (R)		52	51
% of 3‐hourly feeds given (R)		95	72
% where intake was correctly totalled on day 2 (R)		56	62
Treat/prevent hypothermia (keep warm and dry day and night; feed frequently)
% of children with blankets (C)		94	65
% of occasions when room temperature was 25°C or higher (O)		74	97
Treat/prevent dehydration (rehydrate more slowly than usual; do not give intravenous fluids except in shock; monitor closely for signs of overhydration)
% given intravenous fluids on days 1–3 (R)		5.5	6.3
% of those given intravenous fluid where volume was recorded (R)		0 (n = 8)	0 (n = 3)
% diagnosed as severely dehydrated who were recorded as given intravenous/oral fluids (R)		50 (n = 12)	100 (n = 3)
Correct electrolyte imbalance (give extra K and Mg; limit Na; never treat oedema with diuretics)
% given potassium (R)		56	65
% with correct potassium dose (R)		21	23
% given magnesium (R)		81	50
% wrongly given a diuretic for oedema on days 1–3 (R)		0.7	0
Treat infection (give broad‐spectrum antibiotics to all: start straightaway)
% given antibiotic(s) (R)		88	94
% given WHO suggested antibiotics (R)		48	58
% of observations when antibiotics were given on time (O)		33	35
Correct micronutrient deficiencies (give high‐dose vitamin A on day 1; give Zn, Cu, folic acid and multivitamins daily. Do not give Fe at first)
% given vitamin A (R)		86	48
% with correct vitamin A dose (R)		44	41
% given multivitamins (R)		74	80
% given folic acid (R)		83	57
% given zinc and copper (R)		52	30
% with iron correctly withheld in initial phase (R)		98	100
% given iron in catch‐up phase (R)		9	21
Feed cautiously initially (give small amounts of starter formula (F‐75) every 3 h day and night)
% given starter formula (F‐75) (R)		69	91
% prescribed correct feeding volume on day 1 (R)		82	46
% prescribed correct feeding volume on day 3 (R)		65	37
% of reluctant feeders who were encouraged to eat (O)		77	67
Mean number of days on starter formula (R)		3.8	2.6
Rebuild wasted tissues (catch‐up growth) (when appetite returns, make a gradual transition to catch‐up formula (F‐100); give unlimited amounts; also give enriched family foods if aged >6 m)
% moved to catch‐up formula (F‐100) at appropriate time (R)		30	32
% given catch‐up formula (F‐100) (R)		96	100
% prescribed correct feeding volume on transition day 1 (R)		84	36
% prescribed correct feeding volume on transition day 2 (R)		53	17
% prescribed correct feeding volume on transition day 3 (R)		0	5
% fed until full (O)		34	23
% of feedings with oil separating out (O)		97	69
% of children aged >6 months given modified family foods (R)		36	100
Provide stimulation, play and loving care (give loving care, play and stimulation to improve mental development)
% of observations with developmental play sessions (O)		0	0
% of observations with general play observed (O)		24	21
% of contacts when nurses were gentle, caring and loving (O)		47	50
% of observations with toys noted in/around beds (O)		21	8
Mean duration of nurse‐child contacts during 4 h observation (O) (min)		4.2	7.7
Prepare for follow‐up after discharge (teach carers how to continue feeding and care at home; follow up each child regularly to check progress)
% of daytime observations with health education discussions (O)		35	4
% who received a referral letter on discharge (C)		78	57

* C = carer interviews; O, observations; R, record reviews;

Data from the medical records (R) refer to day 1 unless specified.

Day 3 data are reported only if different from day 1.