ComPAS: Combined Protocol for Acute Malnutrition Study health

Simplifying the way acute malnutrition is treated to save lives & improve coverage through cost savings

The current malnutrition treatment is inaccessible for 4 out of 5 acutely malnourished children globally. A new combined approach is simpler, less expensive, & offers more comprehensive treatment, with the potential to reach more children at scale.
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ComPAS: Combined Protocol for Acute Malnutrition Study is at the Scale stage

education

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ComPAS: Combined Protocol for Acute Malnutrition Study

South Sudan, Kenya, Somalia, Mali, Chad

The current malnutrition treatment is inaccessible for 4 out of 5 acutely malnourished children globally. A new combined approach is simpler, less expensive, & offers more comprehensive treatment, with the...

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Globally, approximately 50 million children suffer from acute malnutrition at any given time, including nearly 18 million children the IRC estimates living in conflict and crisis-affected contexts. A cure exists – a simple package of peanut-based paste, delivered through daily doses over a few months – but the system to deliver it is broken, making treatment inaccessible for 4 out of 5 children globally. The IRC, in partnership with Action Against Hunger and the London School of Hygiene and Tropical Medicine, have developed a new approach that offers the promise of simpler, less expensive, and more comprehensive treatment.

Acute malnutrition is a continuum condition meaning a child’s condition improves or deteriorates continuously along a single spectrum. Under the current system, malnutrition is divided into two categories based on severity and treated with two different products in health facilities that are often too distant for families to access. This divided protocol impacts what kind of treatment children can access, where treatment is available to them, and far too often, whether they can access treatment at all.

This simplified protocol treats all acutely malnourished children with the same food product and in the same place, adjusting dosage based on severity. This approach was found to be as effective at recovering children as the traditional treatment method, and offers significant cost savings. It is also simpler for health workers and ensures children are treated before they deteriorate into the more dangerous form of severe malnutrition.

This is one in a suite of solutions the IRC is proposing to create a future in which every malnourished child is treated. Current interventions are overly complex and institutionalized. Our approach empowers families and community health workers to deliver a simplified protocol for treatment with an easy-to-use toolkit. This is a package of care that can be adapted to different contexts, rolled out quickly during times of emergency, and scaled across humanitarian crises.

March 2020 | U.N. recommends simplified approach

U.N. recommends a package of care including simplified protocol and empowering community health workers for nutrition programs affected by COVID-19.

Resource

August 2019 | Begin operational pilot in Chad

Pilot begins in Chad as part of the large-scale, multi-country pilot endorsed by UNICEF, WFP, and ECHO started in December 2018.

December 2018 | Begin operational pilot in Mali

UNICEF, WFP, and ECHO endorse the combined protocol for further exploration and unite to fund and organize a large-scale, multi-country pilot (beginning in Mali) of the combined, simplified protocol. Preliminary results demonstrate safety, feasibility, and cost-effectiveness of these approaches.

August 2018 | End of randomized control trial in Kenya and South Sudan

Results from Kenya and South Sudan demonstrated that the combined protocol is not only successful at recovering children with both SAM and MAM to full health, but reduces the burden on families as well costs to providers.

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July 2018 | Complete stakeholder perspectives study

Study showed that stakeholders in Niger, Nigeria, Somalia and South Sudan were strongly supportive of providing treatment for both forms of malnutrition at the same location. However stakeholders also raised concerns around the proposed diagnostic criterion prioritizing mid-upper arm circumference over weight-for-height z‐score and supply pipeline issues potentially affecting the availability of Ready-to-Use Therapeutic Foods. More research is needed on the clinical efficacy and operational implications of the Combined Protocol.

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March 2018 | Complete operational pilot in Somalia

The simplified protocol achieved a child recovery rate of 98% for children with severe acute malnutrition.

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March 2018 | Begin stakeholder perspectives study

To further understand requirements for adaptation and adoption of the combined protocol in different contexts, the IRC conducts a policy analysis on the use of the protocol in five different food-crisis affected contexts.

January 2018 | Begin operational pilot in Somalia

The IRC begins a prospective cohort study to test an adapted protocol for treating Severe Acute Malnutrition (SAM) in Somalia using Ready-to-Use Therapeutic Food (RUTF) dosage based on the treatment protocol implemented in the ComPAS research trial in Kenya and South Sudan.

May 2017 | Start of randomized control trial in Kenya and South Sudan

Working closely with partners Action Against Hunger and the London School of Hygiene and Tropical Medicine, the IRC implements a randomized controlled research study in Kenya and South Sudan to test a combined protocol to treat children with Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM).

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October 2015 | ComPAS receives funding from CIFF (Children’s Investment Fund Foundation)

May 2015 | End secondary data analysis of Stage 1 of ComPAS

Analysis found that a simplified, combined protocol could enable a more holistic continuum of care, potentially contributing to increased coverage for children suffering from acute malnutrition. This study analyzed data from Chad, Kenya, Yemen, Pakistan, and South Sudan.

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October 2014 | Begin secondary data analysis of Stage 1 of ComPAS

Working with an expert task force of scientists at the London School of Hygiene and Tropical Medicine, Washington University School of Medicine, and University of Tampere/University of Copenhagen, the IRC conducts secondary data analysis of 10,000 acutely malnourished children to propose a new optimized dosage of Ready-to-Use Therapeutic Food (RUTF) to treat Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM).

October 2014 | ComPAS receives initial funding from OFDA (Office of Foreign Disaster Assistance)

The Airbel Impact Lab at IRC is a team of researchers, strategists and innovators committed to the accelerated design, rigorous evaluation and cost-effective scaling of the most impactful solutions supporting people affected by crisis.