Health and nutrition
Health and nutrition
Our aim is to improve the health and nutrition of the poorest and most vulnerable communities. In 2017, Concern’s work helped to improve the health of over five million people, of whom 1.6 million were direct beneficiaries. Over three million were female.
Concern works with vulnerable communities to strengthen maternal and child health, prevent under-nutrition and extreme hunger, improve access to clean water and sanitation and share knowledge on health issues.
Two of our key health and nutrition programmes are Community Management of Acute Malnutrition (CMAM) and Realigning Agriculture to Improve Nutrition (RAIN). CMAM has become an internationally recognised model of best practice endorsed by both WHO and UNICEF. Meanwhile RAIN used a uniquely integrated approach to ensure that nutritious food is grown and consumed to reduce undernutrition and stunting.
Community Management of Acute Malnutrition (CMAM)
In 2000, Concern and Valid International piloted an innovative new approach to dealing with acute malnutrition in Ethiopia. Our approach, called Community Management of Acute Malnutrition (CMAM), has proven to be extremely effective, so much so that it has become the preferred approach for tackling malnutrition internationally.
UN agencies recommend that governments incorporate the CMAM approach - which was piloted by Concern - into their health and nutrition policies. CMAM has now been adopted in over 60 countries worldwide.
The traditional way of treating malnutrition was through therapeutic feeding centres: large centres where patients are admitted for an average of 30 days. This method often forced carers of malnourished children to travel long distances with them to access these centres, in many cases leaving other vulnerable children alone at home.
The central principle of CMAM is to treat malnourished children in their homes. As a result, it reaches more children and reduces the risks and expenses inherent in travel for carers, malnourished children and their siblings.
Children who have been admitted to our programme are provided with weekly medical treatment and given one week's supply of therapeutic food to take home. This micronutrient-enriched food, called ready-to-use therapeutic food (RUTF), is the key to success.
Moving forward with CMAM Surge
To bring our internationally recognised CMAM programme to the next level, Concern is now pioneering a new model of early action – CMAM Surge. Based on lessons learned from the 2010 food crisis in the Horn of Africa, the aim is to help national health systems deal with the large increases in the number of cases of malnutrition that occur during emergencies. The programme also helps to strengthen the capacity of government health systems to better predict, plan for, and respond to periodic surges in cases of severe acute malnutrition and related diseases.
Our CMAM Surge approach has now been used in six countries. A pilot began in Kenya in 2012 and the evaluation is showing promising results. The model has also been piloted in Uganda and Niger, some aspects have been implemented in Chad and Sudan, and we're planning a pilot for Ethiopia.
In Uganda, CMAM Surge has become a part of the National CMAM Guidelines.
The pilot was found to have considerable potential to promote a resilient health system, and workshops were held in east and west Africa in 2016 to encourage the uptake of the approach among partners including NGOs and governments. A global CMAM Surge toolkit is available for practitioners wishing to apply the approach.
Realigning Agriculture to Improve Nutrition (RAIN)
Discover RAIN in detail: visit the RAIN page
Adequate nutrition during a child's first two years – or 1000 days from conception – is vital for healthy growth and development throughout the rest of their lives. In Zambia, 40% of children under the age of five are suffering from chronic malnutrition – that’s almost every second child in the country.
Through our pioneering Realigning Agriculture to Improve Nutrition (RAIN) programme, we worked with communities in Zambia’s Mumbwa district to ensure that nutritious food is grown and consumed, reducing undernutrition and stunting. This meant a uniquely integrated response which tied together agricultural, nutritional, health and gender aspects in one programme.
- RAIN was proven to have consistently positive impacts on agricultural production, on women’s empowerment in the agricultural, social and economic spheres and on household food security.
- The nutrition committee established under RAIN – Mumbwa DNCC – has now been classified by the SUN Committee, and the Zambian Government has decided to scale up the DNCC to 18 other districts across Zambia.
- RAIN won in the "greatest potential impact on nutrition" category of the 2013 SecureNutrition Knowledge Platform awards and was among the award-winning projects showcased at the Harvesting Nutrition event hosted at the World Bank in February 2015.
Based on the bank of knowledge built up through RAIN, a follow-up project called RAIN+, was conceived. Running until June 2018, this new project will have a stronger focus on linking women to markets and on involving men in care practices. It's expected that RAIN+ will deliver important research findings to help the global food and nutrition security community design more effective nutrition sensitive agriulture projects into the future.
- Papers – Reflections on 15 years of CMAM
- Final evaluation paper – CMAM in Nepal
- Outline – CMAM surge model
- Presentation – Surge capacity for CMAM
- CMAM Surge toolkit
- Final RAIN report
- Project brief 1: Rationale, Model and Implementation in Mumbwa District
- Project brief 2: Impact Evaluation: Methods and Baseline Results
- Project brief 3: Intersectoral Coordination and Alignment for Nutrition
- Project brief 4: The importance of gender in agriculture for nutrition
- Project brief 5: Working Multisectorally in Mumbwa District to Improve Nutrition
- Project brief 6: Interpreting the RAIN impact evaluation
- Video presentation – Seven years of CMAM scale up in Malawi
- Centre for Humanitarian Change presentation – CMAM Surge
- Paper – From coherence towards commitment: Changes and challenges in Zambia's nutrition policy environment
- Paper – If they grow it, will they eat and grow? Evidence from Zambia on agricultural diversity and child undernutrition
- Eleanor Crook Foundation (ECF)
- European Civil Protection and Humanitarian Aid Operations (ECHO)
- Irish Aid
- Kerry Group
- UK Department for International Development (DFID)
Accountability is woven into the fabric of all Concern programmes. Learn more about our accountability and transparency procedures and processes, and read our annual report.