Action Against Hunger USA

Transforming Treatment of Acute Malnutrition


We will scale up community-centered approaches for the treatment of acute malnutrition in Sub-Saharan Africa, creating a sustainable model to save millions of children's lives.

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Acute malnutrition threatens the lives of almost 50 million children around the world. While safe and effective treatment exist, 3 out of 4 children are unable to access treatment because of low awareness of the disease, distance from health facilities, availability of quality services and supplies, and national plans that fail to adequately budget and integrate treatment into basic health services. Action Against Hunger, in partnership with No Wasted Lives, seeks to unlock the potential of community-based approaches to treatment in Ethiopia, Mali, Niger, and South Sudan, coordinated through a Transformation for Nutrition Center in East Africa. Our package of interventions, designed for caregivers, community health workers, medical staff, and national Ministries of Health, have already been proven effective. Now, with support from 100&Change, we will have the resources to scale-up treatment at a level never before seen—reaching over 5 million children—and establish a model for broader uptake.

Problem Statement

For too many children around the world, hunger is a life-threatening reality. In 2018, 49.5 million children under age 5 suffered from AM, with almost 1 in 5 of these children in East and West Africa. The last decade has seen enormous advances in AM treatment, with the development of?effective?community-based protocols that hold the promise of treatment at scale. Yet 3 out of 4 children who suffer from the most severe form of AM are still unable to?access?treatment,?leading?to?a vicious cycle of malnutrition, disease, and poverty.?Families with malnourished children face a range of barriers, beginning at the individual and community level, where there is often low awareness of what AM is and how to identify it. For children who are diagnosed with AM, treatment traditionally requires weekly trips to health centers, representing a significant financial and time burden for families. (In Mali and Niger, for example, over half the population lives?outside a 5-kilometer radius of health facilities.) The Community-Based Health Workforce (CBHW) who provide much-needed health services to remote communities often lack capacity and motivation to execute all their duties, as they are not always officially recognized as part of the health workforce and often function on a volunteer basis. Additional factors impacting?coverage include lack of national leadership to develop ambitious scale-up plans, limited technical and financial support, challenges in integrating a single AM treatment service model to different health systems,?and?poor healthcare infrastructure, including availability of water and sanitation.

Solution Overview

Our solution will unlock the potential of community-based approaches to AM treatment across four high-burden countries in East and West Africa:?Ethiopia, Mali, Niger, and South Sudan. By focusing at?a regional?level, we will impact more than 5 million children over the course of the?project and?put forward a durable model that has the potential to increase treatment coverage from 25% to?100%--so that no malnourished children?are?left behind.?? We will promote a package of complementary interventions that will be tailored to each country context, creating a high-impact, replicable model with the following objectives: 1) Healthcare-seeking behaviors of caregivers will increase: training families to use a simple?armband to assess their child’s nutrition status, scaling-up peer support groups, conducting community mobilization 2) Accessibility and availability of nutrition services will increase: scaling-up CMAM, merging AM treatment into the Integrated Community Care Management model (iCCM+Nut) delivered?at household level by CBHWs, ensuring health facilities have adequate water and sanitation to provide safe treatment services 3) Quality of nutrition services will improve: establishing the Transformation for Nutrition Center to serve as the hub for AM treatment knowledge and scale-up (see more details in Durability section), improving CBHW motivation to treat for AM, increased capacity of health facility staff to deliver nutrition services.4) Treatment activities will be costed?and allocated?in national budgets and policies: increasing capacity of Ministry of Health staff to advocate for nutrition resources and improving civil society coordination to influence national guidelines?and policies.

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Project Funders

  • European Civil Protection and Humanitarian Aid 2018 - 2020
  • Office of U.S. Foreign Disaster Assistance 2017 - 2020
  • Swedish International Development Cooperation Agency 2019 - 2020

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