Review of Community-Based Management of Acute Malnutrition (CMAM) in the Post-Emergency Context: Lessons from Ethiopia, Malawi and Niger on Integration of CMAM into National Health Systems

Severe acute malnutrition (SAM) affects approximately 20 million children under five years of age and contributes to more than 1 million child deaths in the world each year. Until recently, treatment of SAM has been limited to facility-based inpatient care. With the availability of an innovative product – ready-to-use-therapeutic food (RUTF) such as Plumpy'nut, it has been possible to manage SAM predominantly in an outpatient setting. The effectiveness of this approach has been documented over the past 5 years mostly in emergency setting by international NGOs. We examined the integration of CMAM services into the national health systems of Ethiopia, Malawi, and Niger in the post-emergency context. This presentation will provide an overview of the three case studies, discuss key elements for quality programming and effectiveness of CMAM services within a framework for CMAM integration, identify challenges and lessons learned from each of the countries, and finally, suggest ways that these lessons can be applied to other countries in the effort to integrate CMAM services into their national health systems.