Training guide for communitybased management of acute malnutrition cmam, 2018 version this cmam training guide is designed for health care managers and providers who manage, supervise, and implement services for the management of acute malnutrition, including those involved in community outreach activities. Action communitybased management of acute malnutrition. Communitybased management of severe acute malnutrition. Evaluation of community management of acute malnutrition.
Communitybased management of severe acute malnutrition in. Treatment of severe and moderate acute malnutrition in low. Kzn guidelines on the integrated management of acute. Programmatically, it is helpful to categorise children with sam into complicated and uncomplicated cases. Since few ngos are currently working in the management of severe acute malnutrition msam in mali, it was possible to visit sites of each program, with the exception of. This is despite clear advances in the development and implementation of international and national protocols for the management of sam, as well as guidelines and training for inpatient care of severely acutely malnourished children. Overview of communitybased management of acute malnutrition cmam. Management of children with severe acute malnutrition in. Review of communitybased management of acute malnutrition implementation in mali, november 18december 3, 2009 2 and national training institutions.
Severe acute malnutrition, community management of acute. Severe acute malnutrition sam is defined as a weightforheight measurement of 70% or less below the median, or three sd or more below the mean national centre for health statistics reference values, the presence of bilateral pitting oedema of nutritional origin, or a midupperarm circumference of less than 110 mm in children age 15 years. Ocha coordinates the global emergency response to save lives and protect people in humanitarian crises. Training guide for communitybased management of acute. Cmam is an evidencedbased model, currently implemented in more than 70 countries worldwide, and is the globally endorsed standard for management of acute malnutrition. District reports combine the information from individual. Malawi guidelines for communitybased management of acute. Admission and discharge criteria for cmam in children under 5. Community management of acute malnutrition cmam guidelines. Assessment of coverage of communitybased management. Perspectives for integration into the local health system.
Pdf globally, acute malnutrition triggers more than 50% of childhood mortality in. The brief focuses on current principles and approaches to moderate acute malnutrition mam management, highlighting key constraints, gaps. Acute malnutrition is classified into severe acute malnutrition1 sam and moderate acute malnutrition mam according to the degree of wasting and the presence of oedema. In recent years, many countries have adopted an exciting new strategy for addressing acute malnutrition. Management of severe acute malnutrition in children. Communitybased management of severe acute malnutrition was introduced in emergency. The community mobilisation part of these guidelines can usefully provide a starting point for such programmes. To assess the feasibility and constraints of communitybased management of acute malnutrition cmam, a relatively new approach, in. Measurements guide for maizecornsoya blend to be used at feeding. Communitybased treatment of severe acute malnutrition sam allows the majority of malnourished children to be treated at an outpatient clinic on a weekly or fortnightly basis with only the most severe cases being admitted to inpatient centres for short periods. Communitybased management of acute malnutrition cmam. Community based management of acute malnutrition cmam. Protocol for the management of severe acute malnutrition.
Tina lloren, regional nutrition advisor, save the children content. Coverage of communitybased management of severe acute. The i nterven tion follow s tw o appr oache s, one appr oach encour ag es local k nowle dge and pr actice s of child. The objective of the study was to assess the preparedness of the health system to implement cmam targeting. Communitybased management of acute malnutrition cmam approach to ensure maximum coverage, timeliness, access. Maternal and child malnutrition is a significant public health problem in south sudan. However, current capacity in the province prevents us from implementing the programme as is, and thus a gradual development towards implementation of. A significant gap remains between need and capacity for management of severe acute malnutrition sam in children. Achieving these goals will maximise impact and the capacity of the service to meet need. National guidelines for community based management of. Much work remains to be done in expanding coverage of cmam.
Acute malnutrition is a major cause of death among underfive children in low and middleincome countries. Communitybased therapeutic care ctc a field manual first edition, 2006 valid international this manual was produced by the ctc research and development programme, a collaboration between valid international and concern worldwide. The communitybased management of acute malnutrition cmam is one of world visions core project models in nutrition. As per the context in ethiopia, a separate set of guidelines applies for. Communitybased management of acute malnutrition cmam brings the. Community based managment of acute malnutrition cmam. Communitybased management of severe acute malnutrition can have a major public health impact with modern treatment regimens and improved access to treatment, casefatality rates can be as low as 5 per cent, both in the community and in healthcare facilities. The aim and priority in communitybased services for the management of acute malnutrition is to reach as many of those affected as possible and to access acutely malnourished children in the early stages of their disease. The cmam approach enables community volunteers to identify and initiate treatment by referring children with acute malnutrition before they become seriously ill. Review of communitybased management of acute malnutrition. Greater emphasis is needed on prevention of sam by strengthening community outreach, mam management and integrating cmam into national health systems and related sectors. Globally, moderate acute malnutrition mam and severe acute malnutrition sam affect approximately 52 million children under five. Pdf communitybased management of acute malnutrition in. The nutrition camps are community based nutrition pr ogr amme s for childr en who ar e a t risk of pr ot ein ener gy malnutrition.
Budhranidoctors for you rural health centre, village masarhi, patna, bihar, india bihar has one of the worst child health indicators with 43% children being underweight, 48% stunted, 53 % being exclusively breastfed for 6 months and only 7 % children getting adequate complementary. Children are reassessed after a period of two weeks and transferred after two months to sfp when their mauc is more than 11. Pdf community management of acute malnutrition in the. Integration of community based management of acute malnutrition. Management of acute malnutrition in infants mami project. We advocate for effective and principled humanitarian action by all, for all. In children aged 659 months, a muac less than 110 mm indicates severe acute malnutrition, which requires urgent treatment. Community based management of acute malnutrition cmam n. This technical brief is one of three commissioned by the communitybased management of acute malnutrition cmam forum.
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