Reflections on 15 years of community based management of acute malnutrition

Reflections on 15 years of community based management of acute malnutrition

29 June 2015

As we reach 15 years since the initial pilot in Ethiopia, we publish two papers to examine the achievements in our community-based management of acute malnutrition programmes.

Luul Ismail and her son Deeqo (2) attending a Concern community-based management of acute malnutrition scheme in Somalia. Photo taken by Jennifer Nolan / Concern Worldwide.

Centralised treatment

During the 1980s and 90s, the prevailing approach to treating severe acute malnutrition involved in-patient therapeutic feeding centres where children could be monitored and administered therapeutic milk feeds and medical treatment round-the-clock. There are a number of disadvantages to this system of treatment including:

  • The need for round-the-clock medical staffing means therapeutic feeding centres tend to be  fewer in number and difficult to reach for the majority of the population
  • Children need to be accompanied by a care-giver, necessitating long absences from home and often meaning many children don’t complete the full treatment
  • Overcrowding can cause cross-infection among children

Change in approach

Two inventions enabled the development of a community-based approach to treating malnutrition:

The main strategy was to decentralise treatment, bringing it as close to the communities in need as possible. In practice, this meant making it possible for the majority of severe acute malnutrition cases to be seen on an outpatient basis.

From pilot to mainstream

Concern and Valid International began engaging in pilots to test this community-based approach in 2000. By 2007, the World Health Organisation, World Food Programme, United Nations Standing Committee on Nutrition and United Nations Children’s Fund issued a joint statement endorsing CMAM.

Today CMAM is implemented in diverse settings, including rapid onset emergencies, urban environments and longer term development settings. Concern has supported CMAM programmes in 16 countries since the initial pilots, and as of 2014 continues to support the programme in nine countries.

For more information on the development of CMAM and the lessons we have learnt from implementation, download the full publications available at the links below.

Download a copy of this resource

Luul Ismail and her son Deeqo (2) attending a Concern community-based management of acute malnutrition scheme in Somalia. Photo taken by Jennifer Nolan / Concern Worldwide.

Reflections on 15 years of community based management of acute malnutrition

As we reach 15 years since the initial pilot in Ethiopia, we publish two papers to examine the achievements in our community-based management of acute malnutrition programmes.
  • Concern worldwides 15 year contribution to community based management of acute malnutrition
    Concern worldwides learning from 15 years of community management of acute malnutrition programming