10 years of community-based treatment of SAM

2

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

10

20

30

40

50

60

70

1 2 3 4 5

9

19

35

48

54 55

61 60

GLOBAL SCALE UP

3

1. National nutrition systems of variable strength

2. Primarily framed as humanitarian activity…..but increasing shift from NGO standalone activity into government public health service

3. Foundation for long term service provision is present……but bottlenecks remain in application

4. Possible to scale up in a short period of time….requiring investments from a wide range of actors

5. Prevention first…..but treatment capacity for those that need it

GLOBAL SCALE UP

4

• Improved mapping data capture and technical support

• Investments in national capacity for nutrition information

• Review of availability, accessibility and coverage data– Geographic coverage: 43%– Treatment coverage: 7-13%

EXPANDING OUR UNDERSTANDING

5

Global burden of Severe Acute Malnutrition (2012)

0.2

0.2

1.5

1.4

1.8

3.0

5.1

9.2

17.3

6

Areas for action remain- creating demand• CHWs systems and beyond?• Creating a constituency by engaging civil society

Areas for action remain- creating supply • Strengthening the continuum of care • Integration into health services (DHSS, ICCM, WHO/UNICEF Task

Force on Integration)• Costings for SAM/nutrition and integration into government

budget lines• Addressing vulnerable groups (including other age groups),

technical issues and evidence gaps, methods to identify differing subnational needs

EQUITABLE ACCESS

7

Areas for action: capacity to deliver• Critical role of supervision and investment in local

capacity at facility and community level • Integration across nutrition and health (e.g. IYCF and HIV)

Areas for action: Therapeutic supplies• Product specifications and reference standards limited,

undermining national registration• Local production capacity and formulations more

complex and expensive than anticipated• Supply chain management capacity• Sourcing routine medications

QUALITY OF SERVICES

8

Areas for action• Strengthen routine SAM management data by building off of

existing systems– Address methodology issues- Capacity for collection, analysis and

promotion of data use (supervision)– Innovation – rapid SMS and real time information– Strengthen Global SAM tool

• Review and consolidate definition of geographic coverage

• Improving treatment coverage methods – Strengthening the evidence base– Developing technical and operational framework for national

treatment coverage estimates– Integrate coverage into routine nutrition information systems

NUTRITION INFORMATION

9

Prevention first…

…but treatment is urgently needed for those who are malnourished

IN SUMMARY