Malnutrition
Scaling Treatment for Acute Malnutrition
The Problem
The IRC estimates that 18 million children living in humanitarian crises are suffering from acute malnutrition at any given time, despite the existence of a proven solution - a simple packet of fortified peanut butter paste. However, only 20% of acutely malnourished children are accessing this treatment, despite its known effectiveness.
Why current approaches are inadequate
The current system and infrastructure that exists to deliver treatment is complex, costly, and chronically underfunded. The current status quo unnecessarily divides children into moderate and acute malnutrition, which is served by two different UN agencies, using separate facilities, protocols, and supply chains. The unnecessary complexity has been costly and stunted scaling of treatment.
Our solution
This simplified approach relies on a color-coded, numbered measuring tape to diagnose a child and a nutritional peanut paste known as ready-to-use therapeutic food (RUTF). Central to scaling this approach is the role of Community Health Workers (CHWs), able to bring this lifesaving care directly to affected communities. This approach is scalable, less expensive and proven to help more than 90 percent of malnourished children treated with it recover and have a chance at life. It has also proven it can be more cost-effective and efficient than many current approaches, with some estimates counting the simplified approach as costing 20% less per child treated and uses 25% less product than the traditional protocol. In a study of 27,800 children treated using the combined protocol in Mali, the IRC found that 92 percent of those treated recovered within weeks.
Shifting the status quo
IRC has been researching simplified approaches for treatment of acute malnutrition for a decade and the body of research is now significant. The evidence is consistent that simplified approaches, including middle-upper-arm-circumference tab-based and simplified dosing, are more cost-effective ways to treat acute malnutrition with the same recovery rates compared to the original protocol. We therefore support the range of simplifications and adoption of all effective simplified approaches, including those in the WHO wasting treatment guidelines, that expand reach of treatment and/or result in reduced costs. The humanitarian sector should adopt simplified approaches as the standard of care for acute malnutrition. This is part of IRC's Movement Against Malnutrition.
Related Projects
ComPAS: Combined Protocol for Acute Malnutrition Study
Simplifying the way acute malnutrition is treated to save lives & improve coverage through cost savings
Explore ProjectComPAS: Combined Protocol for Severe and Moderate Acute Malnutrition Study
Effectiveness of a Simplified Protocol for Community Health Workers to Treat Severe Acute Malnutrition (SAM) in an Emergency-Prone Setting
Relapse after treatment of acute malnutrition
Relapse post-discharge from acute malnutrition treatment remains a largely neglected issue
Explore ProjectSQ-LNS to reduce relapse post-discharge from acute malnutrition treatment
Small-quantity lipid-based nutrient supplements (SQ-LNS) hold promise for preventing relapse in an efficient and cost-effective way
Explore ProjectTreatment of severely underweight children
Testing the efficacy of treatment of severe underweight in children 6-59 months with different nutritional protocols in Mali
Explore Project
Latest Updates
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Effectiveness of acute malnutrition treatment with a simplified, combined protocol in Central African Republic: An observational cohort study
The simplified, combined protocol with a mid-upper-arm circumference (MUAC)-based ready-to-use therapeutic food (RUTF) resulted in a recovery rate that reached SPHERE standards, low length of stay and low RUTF consumption per child among all children treated.
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Nutritional treatment of children 6–59 months with severely low weight-for-age z-score: a study protocol for a 3-arm randomized controlled trial
Nutritional treatment of children 6–59 months with severely low weight-for-age z-score: a study protocol for a 3-arm randomized controlled trial
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Optimising ‘family MUAC’: Findings from a pilot study in Mali
Worldwide, only 20% of an estimated 50 million children afflicted by severe wasting receive life-saving treatment each year. The biggest gap to treatment coverage is identification of cases and referrals to treatment.
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The effect of age rounding on weight-for-age z-scores: Evidence from Sub-Saharan Africa
Children aged 6–59 months are classified as malnourished when their weight-for-age z-score (WAZ) is lower than minus two standard deviations (< -2 SD) below the median on the 2006 World Health Organization growth standards (WHO, 2006).
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No child faces: Examining the use of child images from nutrition assessments
The use of child images, particularly in the humanitarian sector, is problematic. In the worst cases, child images are used by nonprofits and charity organisations to gain sympathy and donations by showing exploitative imagery of people living in destitute conditions – referred to as ‘poverty porn’.2 More ubiquitously, pictures of identifiable minors in humanitarian contexts continue to be relied on for internal communications, fundraising campaigns, technical guidelines, articles, case studies, grey literature, and donor reports. This is despite existing guidelines and the sector espousing a central ‘Do no harm’ principle.
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Cost-efficiency of a simplified protocol for wasting treatment in Mali
The treatment of wasting is currently divided into separate programmes based on severity. Uncomplicated severe wasting is treated through outpatient therapeutic feeding programmes, whereas moderate wasting is often treated through supplementary feeding programmes. While wasting is essentially a spectrum from mild to moderate to severe – with cutoffs acting as necessary proxy thresholds to designate treatment – these treatment programmes often run independently from each other with different sites, treatment days, and using different products with their own supply chains.
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Post-Recovery Relapse of Children Treated with a Simplified, Combined Nutrition Treatment Protocol in Mali: A Prospective Cohort Study
The present study aimed to determine the 6-month incidence of relapse and associated factors among children who recovered from acute malnutrition (AM) following mid-upper arm circumference (MUAC)-based simplified combined treatment using the ComPAS protocol
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