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Tackling malnutrition in Malawi

Concern's innovative method of dealing with malnourishment in children has had great success in Malawi.

This article, by Concern's Louise Finan, originally appeared in the Malawian newspaper "The Nation".

Walk into any child health clinic in Nsanje, you are likely to hear mothers discussing the benefits of the community-management of acute malnutrition (CMAM)* programme which treats malnourishment in children.

You will hear them exchange stories of what they heard about the programme, either from other mothers whose children are now well and healthy, from community health workers or indeed from their own chiefs.

Addressing malnutrition

While these mothers chat, health workers weigh and measure the children, ensuring that every child is putting on weight and growing at the rate he or she should be. These children are also checked for signs of other illnesses should they need to be treated at the district hospital. They are given nutrient-rich “ready to use therapeutic food” (RUTF), known locally as chiponde. The RUTF is already mixed to ensure that mothers can feed their children even while working in the fields.

This programme has come a long way in addressing malnutrition in Ksanje’s children.

Kenneth Ndau, maternal and child coordinator for Nsanje district, explains “Malnutrition is high in Nsanje, but we are doing our level best to reduce it through the CMAM programme. We have been developing the skills of our staff to ensure that CMAM is implemented correctly.

Now that we are doing well and feeling confident with CTC, we are looking at integrating it with other child health programmes.”

CMAM was introduced to Malawi in 2002 in coordination with the Malawian Ministry of Health, Concern and Valid International. Since then, with the support of the CMAM Advisory Service (CAS), the ministry has become one of the world leaders in implementing this approach.

Sharing experiences

In fact, Health Minister Khumbo Kachali recently hosted a learning workshop on CMAM for health and nutrition experts from across Africa. Delegates from NGOs and the Ministry of Health in Botswana, Ghana and Uganda joined forces with their Malawian counterparts to share experiences and learn more on how they could implement CMAM in their countries.

Kijogo Siraje, a Ugandan nutritionist explains: “While Uganda has begun the process of planning how to begin to using this approach, it is sometimes difficult to know how to practically use it. During our stay in Malawi, we have visited health centres and are able to work alongside our Malawian counterparts. This gives us greater practical experience on what to do when we return home.”

Maternal and child health coordinator for Mzimba, Zefton Disi, has been involved in using this approach in his district. “We are extremely proud that this conference has taken place in Malawi. At first, we had no idea how far ahead Malawi was in implementing this approach, but now I see how much we have already done. It has been great to share experiences, and be an important part of the learning process for other countries that are planning to do this,” Disi says.

He also states that this international training would bring renewed enthusiasm to pressing ahead to ensure that CMAM was fully integrated into the Malawian Health Care Package.

“Although we are still in the process of scaling-up this approach to all districts and health centres, we are confident in how well it works. In fact, a number of district health offices have already planned to fund some of these activities in their district budgets, showing their commitment to it. I believe over time we can really achieve to fully take this on,” he says.

*CMAM was known as community therapeutic care, or CTC, prior to 2011.