Managing severe acute malnutrition in children

Between one and two million children die each year around the world from wasting, or severe acute malnutrition (SAM) due to poverty and poor diet. Nevertheless SAM has been ignored by health programmes and the World Health Organization (WHO) does not recognise the term ‘acute malnutrition’.

Valid International (UK) has been studying ways of improving care for these severely malnourished children. SAM is diagnosed in young children whose weight is more than 70 percent below the average for their height or who have an upper-arm circumference of less than 11cm. Hospital mortality rates for children with SAM have remained unchanged since the 1950s at 20-30 percent even though there have long been ways of reducing mortality to below five percent. Even more worryingly, hospital treatment reaches less than 10 percent of children who need it.

If trained staff looked after children in well-provisioned hospitals using the latest protocol survival rates would increase dramatically. However, these children live in the poorest regions of the poorest countries in the world. There are not enough hospital beds or trained medical staff to care for them. Other ways of saving these children’s lives must be found.

Community-based therapeutic care is much cheaper and can reach many more children than traditional hospital-based care. Health programmes which provide children with ready-to-use food have proved successful. The special nutrient-dense food, with added minerals and vitamins, does not need cooking and can be kept unrefrigerated for several months. Moreover, the food can be made from local crops using basic local technology. The studies found that when children suffering from SAM were treated in the community:

Economic development and public health programmes to improve diet in these regions would prevent almost all of these deaths. The study recommends that:

‘Management of severe acute malnutrition in children’, The Lancet 368, pages 1992-2000, by Steve Collins, Nicky Dent, Paul Binns, Paluku Bahwere, Kate Sadler and Alistair Hallam, 2006 Full document.

Funded by: Concern Worldwide

id21 Research Highlight: 30 March 2007

Further Information:
Steve Collins
Valid International Ltd
Unit 14, Standingford House
26 Cave Street

Tel: +44 (0) 1865 722180
Fax: +44 (0) 8709 223510
Contact the contributor: steve@validinternational.org

Valid International, UK

Other related links:
'Community treatment for HIV-related malnutrition in Malawi'

'Hunger crisis: learning from southern Africa'

'Community therapeutic care – a new strategy for treating malnourished children in Ethiopia'

'Why food comes first in the fight against HIV and AIDS'

'Community support is associated with better antiretroviral therapy outcomes in Malawi'

'Community-based Therapeutic Care (CTC)', Emergency Nutrition Network (ENN) Special Supplement in Field Exchange Issue 23, by Tanya Khara and Steve Collins, 2004 >

'Community Therapeutic Care (CTC): A new approach to managing acute malnutrition in emergencies and beyond', Food and Nutritional Assistance Technical Note 8, by Caroline Grobler-Tanner and Steve Collins, June 2004 (PDF)

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