Article révisé par les pairs
Résumé : This paper analyses the effectiveness of case management at referral level for malnourished sick children in a rural district health system in the south of Chad (Pala district). The methodology followed was based on a cohort study of malnourished children as well as a cost-effective analysis of alternative options for nutritional rehabilitation strategies. Results show that effective case management at hospital level is possible with few resources as long as the nutritional rehabilitation programme is implemented on an integrated basis including early diagnosis of malnutrition for all children admitted to hospital and not to wait for a normal weight-for-height but discharge when the hospital is no longer the best place to avoid further mortality.