Community-based management of severe acute malnutrition

 

Severe acute malnutrition remains a major killer of children under five years of age. This report advocates the community-based approach, which involves timely detection of severe acute malnutrition in the community and provision of treatment for those without medical complications with ready-to-use therapeutic foods or other nutrient-dense foods at home. If properly combined with a facility-based approach for those malnourished children with medical complications and implemented on a large scale, community-based management of severe acute malnutrition could prevent the deaths of hundreds of thousands of children.

 

It is advised that countries can save children’s lives by:

 

Adopting and promoting national policies and programmes that:

• Ensure that national protocols for the management of severe acute malnutrition have a strong community-based component that complements facility-based activities. 
• Achieve high coverage of interventions aimed at identifying and treating children in all parts of the country and at all times of the year through effective community mobilization and active case finding. 
• Provide training and support for community health workers to identify children with severe acute malnutrition who need urgent treatment and to recognize those children with associated complications who need urgent referral.
•  Establish adequate referral arrangements for children suffering from complicated forms of severe acute malnutrition so they can receive adequate inpatient treatment.
• Provide training for improved management of severe acute malnutrition at all levels, involving an integrated approach that includes community- and facility-based components. action, be added to the list of cost-effective interventions to reduce child mortality.

Providing the resources needed for management of severe acute malnutrition, including: 

• Making RUTF available to families of children with severe acute malnutrition through a network of community health workers or community-level health facilities, preferably by encouraging the local food industry to produce RUTF in settings where families do not have access to appropriate local foods.
• Ensuring funding to provide free treatment of severe acute malnutrition because affected families are often among the poorest. 

 Integrating the management of severe acute malnutrition with other health activities, such as: 

•  Preventive nutrition initiatives, including promotion of breastfeeding and appropriate complementary feeding, and provision of relevant information, education and communication (IEC) materials. 
• Activities related to the Integrated Management of Childhood Illness at first-level health facilities and at the referral level, and initiating such activities where they do not exist.