Average Length of Stay

Outcome

average length of stay, in days, among children aged 6–59 months discharged as recovered from acute malnutrition treatment

The indicator measures the average number of days that children discharged as recovered spend in an acute malnutrition treatment programme. It can help assess programme performance and treatment duration, but it should not be interpreted as a stand-alone measure of quality because it is influenced by treatment protocol, severity at admission, recovery criteria, and attendance.

Define the treatment population, treatment modality (if relevant) and reporting period before calculating the indicator. For each child aged 6–59 months discharged as recovered during the reporting period, calculate the number of days from the relevant admission date to discharge as recovered. Follow applicable national guidance when defining admission and treatment episodes, including for children transferred between inpatient and outpatient care. Sum these individual lengths of stay and divide by the number of recovered children included. Calculate separate results for different treatment populations or modalities, such as SAM and MAM or inpatient and outpatient care, where these are reported separately.

This data can be disaggregated by geographic area, sex and age group, and, if relevant and feasible, also by treatment site or treatment modality.

1) The indicator does not require a separate survey – the required data can be obtained from the treatment programme’s routine records.

    

2) Interpret this indicator together with recovery, death, default and non-recovery rates. It includes only children discharged as recovered, so a short average stay among recovered children can coexist with poor outcomes among children who did not recover.

3) Older CMAM reporting guidance used 45–60 days as a reference for therapeutic care, but this should not be treated as a universal target. Sphere 2018 advises following applicable national guidance because expected length of stay depends on context. Compare results only where admission criteria, recovery criteria and treatment models are sufficiently similar. Longer stays can indicate treatment or access problems, but may also reflect greater severity or comorbidity; shorter stays are not automatically better if recovery criteria are not met.

Also consider using the following indicators:

• Recovery (Cure) Rate (shows the proportion of discharged children who actually recover)

• Death Rate (identifies adverse treatment outcomes that average length of stay excludes)

• Default Rate (helps identify attendance and access problems affecting treatment duration)

• Non-Recovery Rate (identifies children who leave treatment without meeting recovery criteria)