A Focus on Malnutrition

Good nutrition is essential for the human body to grow and develop as it should. Under-nutrition is one of the most serious, yet least addressed, development challenges in the world today, affecting a quarter of the world’s population. Under-nutrition is caused by inadequate intake or poor absorption of nutrients in the body. There are four forms of under-nutrition: acute malnutrition, stunting, underweight and micro nutrient deficiencies. The four forms can be categorized as either moderate or severe malnutrition and can appear isolated or in combination. Severe acute malnutrition (SAM) is characterized by the presence of bilateral pitting edema or severe wasting. People with SAM are extremely vulnerable.

Poor nutrition increases the chances of experiencing specific health problems and can lead to anemia, reduced immunity, and impaired physical and mental development (WHO, 2014).  Repeated treatment of malnutrition and related illnesses burden individuals, health systems and entire societies (The Cost of Hunger, 2014). In fact, the estimated impact on the global economy could be as high as US$3.5 trillion per year. More importantly, malnutrition is one of the biggest contributors to high mortality rates among children in many nations.

Challenges to solving malnutrition are now getting much needed attention. The international community is recognizing that policy action is urgently in need  (Global Panel on Agriculture and Food Systems for Nutrition). Most recently the Sustainable Development Goals were developed that aim to end hunger and food insecurity to bring about change that improves nutrition around the globe. The Scale Up for Nutrition (SUN) movement engages government in policy change and action to address malnutrition. There are currently 57 countries that are now participating in the SUN Movement.

Mothers and children in Makeni, Sierra Leone

Sierra Leone women and children wait to be seen at this peripheral health unit in Makeni

Two Models for Management of Acute Malnutrition

Two models that are being used to address malnutrition in a number of countries include:

  1. Integrated Management of Acute Malnutrition (IMAM) and a community approach.
  2. Community Management of Acute Malnutrition (CMAM).

Most programs target vulnerable children under five years of age and pregnant or lactating mothers.

What Programs Provide

IMAM programs provide treatment and focus on the integration of the management of acute malnutrition into the on-going routine health services at all levels. On the other hand, CMAM usually involves community engagement for referral of cases using a system that involves support for existing health systems that need improvement. Ideally, these two models work hand in hand. Through CMAM, referrals are sent to treatment facilities and sometimes community even delivers supplemental foods to hard-to-reach communities. IMAM is a treatment program that treats and tracks severe acute malnutrition cases. It also provides supplements including micronutrients to aid in treatment.

Studies have shown the importance of a more integrated approach to acute malnutrition. One that requires holistic multi-sector strategies, engagement of agriculture and economic development sectors in order to prevent malnutrition.  Governments interested in building resilience are recognizing the importance of developing emergency response systems. These response systems create cushions that help protect against shocks that are caused by climate change and epidemics, that can devastate vulnerable populations.

Global Health Liaisons has completed two evaluation studies of programs seeking to shift their target areas from critical malnutrition situation to one that is stable. See more about our studies under projects.

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