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The purpose of this Operational Guideline is to support state health authorities, programme managers and health care professionals with recommendations on appropriate management of children with SAM in the health facilities. Facility based management includes setting up and managing within the healt
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h facility premises, a functional space where these children are cared for. This Facility Based Unit is referred to as Nutritional Rehabilitation Centre or NRC in the document. While the scale and design may vary in a given situation, it is intended that the document provide the basis for a consistent set of principles that can be used by all states for facility based management of children with SAM. The Operational Guideline focuses on the Facility/Hospital based approach for the management of SAM children under 5 years of age based on the WHO and revised IAP protocols.
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The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of
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age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can range between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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Review of Community-Based Management of Acute Malnutrition Implementation in Burkina Faso
Deconinck H., S. Diene, P. Bahwere
Food and Nutrition Technical Assistance II Project (FANTA-2)
(2010)
C2
The United States Agency for International Development (USAID) Bureau for Democracy, Conflict, and Humanitarian Assistance Office of U.S. Foreign Disaster Assistance (DCHA/OFDA) requested Food and Nutrition Technical Assistance II Project (FANTA-2) assistance to review Community-Based Management of
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Acute Malnutrition (CMAM) in four West African countries—Burkina Faso, Mali, Mauritania, and Niger—to help identify DCHA/OFDA 2010 and 2011 program priorities, including where DCHA/OFDA investment should be directed to support CMAM. The goal was to review CMAM program implementation and its integration into national health systems to provide DCHA/OFDA a status report for each country; draw lessons learned; and make recommendations on challenges, promising practices, gaps, and priority areas for DCHA/OFDA support during 2010 and 2011. The review was intended for DCHA/OFDA program planning purposes and also potentially as an advocacy tool to guide other donors in planning CMAM support in the region. After all four countries have been reviewed, FANTA-2 will develop a synthesis report. The current document presents a summary report on CMAM in Burkina Faso only.
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The risk of increasing rates of acute malnutrition during the COVID-19 pandemic demonstrates the urgent need to adapt, and expand access to, acute malnutrition diagnosis and treatment services in hu
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manitarian and fragile contexts.
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Community-Based Management of Acute Malnutrition (CMAM) is a decentralised community-based approach to treating acute malnutrition. Treatment is matched to the nutritional and clinical needs of the
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child, with the majority children receiving treatment at home using ready-to-use foods. In-patient care is provided only for complicated cases of acute malnutrition. CMAM consists of four components: (1) stabilisation care for acute malnutrition with complications, (2) out-patient therapeutic care for severe acute malnutrition without complications, (3) supplementary feeding for moderate acute malnutrition and (4) community mobilisation.
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The document is a comprehensive practical guide for managing cholera epidemics. It includes detailed instructions on outbreak investigation, control measures, case management, and the organization of treatment facilities. It emphasizes strategies such as rehydration therapy, water sanitation, hygien
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e promotion, and vaccination to prevent the spread of cholera. The guide serves as a resource for healthcare professionals, logisticians, and public health officials to respond effectively to cholera outbreaks.
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The acute food insecurity and malnutrition situation in South Sudan is deteriorating as a result of the economic crisis, repeated climatic shocks – primarily widespread flooding – and conflict and insecurity. The inflow of returnees and refugees
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fleeing the conflict in Sudan is exacerbating the situation – putting additional pressure on an already fragile country.
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WHO child growth standards and the identification of severe acute malnutrition in infants and children
recommended
A Joint Statement by the World Health Organization and the United Nations Children’s Fund.
In-and Out-Patient Treatment
Public Health Action PHA 2017; 7(2): 110–115
Level of stunting among Bangladeshi children <5years declined from 51% in 2004 to 36% and underweight from 41% in 2007 to 33% (BDHS 2014). But the decrease in wasting rate is not as expected, which is only from 17% to 14.3 % over last decade. Approximately 3.1 % (BDHS 2014) of under-5 children suffering from SAM only b
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y weight-for-length or height z-score (WHZ) <-3 criterion and estimated to be a total of ~ 450,000. Because, there are no national information on prevalence of SAM using mid upper arm circumference (MUAC) and presence of bipedal oedema in under-5 children, thus the actual number of children suffering from SAM could be much higher than the current estimate.
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La mission d’évaluation au Bénin a été coordonnée et organisée par Anne-Sophie Le Dain, nutritionniste à l’UNICEF-Cotonou et Félicien Agossou Sagbadja, nutritionniste à l’UNICEF-Parakou. Elle a inclus la visite du Service National de Nutrition (SNN), de la section Survie UNICEF ainsi
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que de son représentant, la participation à la révision du protocole sur la prise en charge de la malnutrition aiguë et enfin la visite des centres de prise en charge intégrée de la malnutrition aiguë dans le département de l’Alibori dans les zones sanitaires de Malanville Karimama, Kandi-Gogounou-Segbana et Banikoara
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Manual of Operations
First Edition 2016
This Guidance Document provides practical assistance to Country Offices scaling up programmes to manage SAM in young children. It outlines a step-by-step process through which countries can analyse their current situation, identify barriers and bottlenecks through the MoRES approach, and plan action
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to scale-up treatment. In particular it addresses the challenge of supporting governments to accelerate and sustain scale-up, build national capacities and source reliable and sustained supplies and financing for managing SAM. This document also provides complementary background information, references to international technical recommendations, resources and tools.
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This summary assesses the current state of evidence on each approach in tabular form, providing: the definition and objectives; evidence of effectiveness; operational considerations (e.g., training, staffing, and logistics); cost considerations and evidence on cost-effectiveness; operational success
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es and challenges; and areas for future research and learning. This document is not intended to endorse any particular approach. Rather, it aims to objectively present the state of the existing evidence on each approach, so as to inform decision-making among practitioners looking to further test, refine and implement such approaches.
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