Effectiveness of a Simplified Protocol for Community Health Workers to Treat Severe Acute Malnutrition (SAM) in an Emergency-Prone Setting

Malaria, diarrhea, and pneumonia account for the majority of under-five deaths globally with malnutrition contributing to half of these. Providing timely treatment is one of the most effective interventions for reducing mortality; however, in most humanitarian contexts with high mortality rates, facility-based or mobile services do not provide adequate access to treatment. When low-literate CHWs are trained on simplified guidelines, supported with supervision, and provided an uninterrupted supply of medicines, they can identify and correctly treat most children who have pneumonia, malaria, and diarrhea, and they can do so in places humanitarian actors cannot access. In areas of South Sudan where IRC supports iCCM, it has previously been shown that CHWs provide ten times more treatments than health facilities. Through a feasibility study, we tested the feasibility of integrating the treatment of SAM into the iCCM approach to deliver medical treatment by CHWs in inaccessible areas and assess impact on child morbidity and coverage by this approach. The treated children had a recovery rate of 91% to moderate acute malnutrition (MAM) and 75% to full recovery.