Category: Treatment of severe malnutrition
This article describes MSF’s experience of implementing a therapeutic feeding programme for adults in Wau, southern Sudan in 1998.
Issue 15, April 2002 (page 11)
This article shares the preliminary results of an exploratory trial of a ready-to-use therapeutic food based on soy, lentils and rice, produced in Sri Lanka.
Issue 39, September 2010 (page 13)
Developing CTC programmes that use Ready to Use Therapeutic Food (RUTF) made locally, from locally available produce, and used to treat malnutrition and HIV amongst the local population, is an important vision for the future of CTC.
Supplement 2, November 2004 (page 35)
Faryab province is in a remote and poor area in the north of Afghanistan. There is little infrastructure, a high risk of disease outbreaks such as cholera and measles, and malnutrition is endemic.
Issue 19, July 2003 (page 14)
Summary of published paper.
Issue 14, November 2001 (page 6)
Socio-economic status The Republic of Sierra Leone is situated on the West Coast of Africa, bordering the North Atlantic Ocean, between Guinea and Liberia. Its land area covers approximately 71,740 sq. km. The estimated projected population for 2011 is 5,876,936 inhabitants, of which approximately 37% reside in urban areas.
Issue 43, July 2012 (page 40)
Generally, emergency interventions are conceptualised as having an impact on nutritional status through a combination of strengthening food security, health service provision and providing or supporting caring practices.
Issue 4, June 1998 (page 4)
Most people will have come across cellophane, its the packaging for many sweets, pies and other goodies.
Issue 1, May 1997 (page 10)
Zimbabwe has a high prevalence of stunting (32%) and low prevalence of wasting/acute malnutrition (3%) (DHS 2011).
Issue 43, July 2012 (page 97)
This article describes the main findings of a clinical trial by ACF in Sierra Leone, which compares the use of solid RUTF (BP100) with the standard F100 treatment, during the rehabilitation phase of a TFC.
Issue 24, March 2005 (page 22)
State-level actors in India have been quick to use the momentum established at the Community based Management of Acute Malnutrition (CMAM) Conference in Addis Ababa to take forward the severe acute malnutrition (SAM) agenda.
Issue 43, July 2012 (page 88)
Globally, more than 3.5 million children under the age of five year die each year due to the underlying causes of malnutrition. It is also estimated that 13 million infants are born each year with low birth weight (LBW), 55 million children are wasted (of which 19 million are severely wasted) and 178 million are Stunted.
Issue 43, July 2012 (page 16)
Summary of published paper.
Issue 14, November 2001 (page 4)
Mozambique has just over 20 million inhabitants, of whom approximately 17% are less than five years of age. More than half of the population (55%) lives in poverty.
Issue 43, July 2012 (page 46)
Over the last few years of CTC development, the process of community participation and mobilisation has become central to the search for more efficient and more sustainable strategies to manage malnutrition.
Supplement 2, November 2004 (page 43)
A three day meeting was held in Dublin hosted by Concern and Valid International between 8-10th of October, 2003 on community-based treatment1 of the severely malnourished.
Issue 21, March 2004 (page 16)
Summary of published research.
Issue 20, November 2003 (page 5)
In November 2011, ENN, in collaboration with the Government of Ethiopia (GoE) hosted a 4-day conference in Addis Ababa at which Government representatives from 22 countries in Africa and Asia, as well as members of international non-governmental organisations (NGOs), UN agencies, the private sector, academic institutions and donor agencies came together to share experiences and to identify lessons for further future CMAM scale up.
Issue 43, July 2012 (page 64)
Summary of published research.
Issue 41, August 2011 (page 24)
Aretrospective study was recently conducted in SNNPR, Ethiopia to determine the average cost of treatment of a severely malnourished child in a therapeutic feeding centre (TFC) and in a community based therapeutic care (CTC) programme, to determine the effectiveness of TFC and CTC programmes as measured by the clinical outcomes, and to compare the cost effectiveness of the two approaches.
Issue 41, August 2011 (page 22)
The Community based Management of Acute Malnutrition (CMAM) approach aims to increase the coverage and accessibility of treatment for acute Malnutrition.
Issue 43, July 2012 (page 74)
Community Therapeutic Care (CTC) is a community-based model for delivering care to malnourished people. CTC seeks to provide fast, effective and cost efficient assistance in a manner that empowers the affected communities and creates a platform for longer-term solutions to the problems of food security and
public health.
Supplement 2, November 2004 (page 6)
North Darfur state lies 1000 km to the west of Khartoum. It is an area the size of France but is inhabited by only 1.4 million people.
Supplement 2, November 2004 (page 22)
In May 2003, a new publication, Caring for severely malnourished children, Ashworth and Burgess, 2003 1 , met with some technical criticism from Professor Mike Golden in the form of a book critique submitted to ENN, and circulated to the publishers and supporting agencies (see Field Exchange 19, pp 19).
Issue 20, November 2003 (page 16)
This article describes experiences and observations around the successful decentralisation and scale up of the outpatient management of severe acute malnutrition in Ethiopia in the period 2008 to 2010. It includes achievements, the challenges around monitoring and reporting and ongoing steps needed to strengthen and assure service quality.
Issue 40, February 2011 (page 39)
This article describes the large-scale rollout of outpatient therapeutic care in Ethiopia in response to the 2008 escalation in severe acute malnutrition.
Issue 36, July 2009 (page 12)
A recently published paper reports the results of a study conducted by Concern Worldwide on severely malnourished adults in Baidoa, Somalia, a town at the epicentre of the 1992 famine.
Issue 6, February 1999 (page 11)
As global interest in Ready-to-Use Therapeutic Foods (RUTFs) has risen, their use has begun expanding beyond the realm of treating children with severe acute malnutrition (SAM). Of recent interest within the humanitarian community is the use of such products in treating malnourished adults living with HIV/AIDS.
Issue 40, February 2011 (page 83)
Cette édition spéciale de Field Exchange consacrée aux « Leçons pour le déploiement de la prise en charge communautaire de la malnutrition aiguë (PCMA) » vise principalement à fournir des éclairages sur le déploiement de la PCMA d’un point de vue gouvernemental. Une grande partie de ce numéro porte en conséquence sur le déroulement de la conférence internationale sur les expériences gouvernementales en matière de déploiement de la PCMA qui s’est tenue à Addis-Abeba du 14 au 17 novembre 2011.
Issue 43, July 2012 (page 2)
Community-based management of acute malnutrition (CMAM) has been implemented in Ethiopia by various non-governmental organisations (NGOs) in response to emergencies.
Issue 34, October 2008 (page 8)
Like most developing countries, Ghana is faced with high rates of malnutrition. According to the Ghana Demographic and Health Survey (GDHS) 2008, 14% of children under five years are underweight, 28% are stunted and 9.0% wasted.
Issue 43, July 2012 (page 22)
Research has shown that the survival rate of malnourished children during food crises critically depends not just on the availability of appropriate therapeutic food, but also on the emotional and physical stimulations available for both the child and the caregiver (usually the mother).
Issue 40, February 2011 (page 85)
Summary of presentation.
Issue 19, July 2003 (page 28)
In 2010 and 2011, FANTA-2 conducted a series of reviews of community based management of acute malnutrition in Mauritania, Burkino Faso, Mali, Niger, Sudan and Ghana.
Issue 43, July 2012 (page 65)
Summary of Conference Presentation.
Issue 2, August 1997 (page 14)
Summary of published research.
Issue 37, November 2009 (page 10)
In 2010, UNICEF approached VALID International to design and conduct a global mapping review of Community-based Management of Acute Malnutrition (CMAM) with a focus on severe acute malnutrition (SAM).
Issue 43, July 2012 (page 58)
This article describes the experiences of ACF, Save the Children and UNICEF in supporting government scale up of CMAM programming in Nigeria.
Issue 43, July 2012 (page 90)
This Field Exchange special issue on ‘Lessons for the scale up of Community-based Management of Acute Malnutrition (CMAM)’ mainly aims to provide some insights on scaling up CMAM from a government perspective. A large part of this edition is therefore taken up with the proceedings of an international conference on government experiences of CMAM scale up held in Addis Ababa, 14-17 November, 2011.
Issue 43, July 2012 (page 2)
A key thematic focus of this issue of Field Exchange is Humanitarian Reform. There have been many reviews and evaluations concerning the level of progress made since the reform process was officially launched some five years ago.
Issue 39, September 2010 (page 2)
Summary of review.
Issue 41, August 2011 (page 11)
This article describes a modification of the centric systematic area sampling method using GPS, to overcome field constraints related to mapping and active case finding.
Issue 35, March 2009 (page 36)
This article describes the positive experiences of the St Louis Nutrition Project using Ready to Use Therapeutic Food (RUTF) in Malawi, and how this approach was integrated into the existing national network for managing severe and moderate malnutrition.
Issue 21, March 2004 (page 12)
In July 2006, ACF-USA implemented an out-patient programme for the treatment of severely malnourished children in the main internally displaced people (IDP) camps of the districts of Lira and Apac, Northern Uganda.
Issue 34, October 2008 (page 15)
In Malawi, chronic malnutrition (stunting) is estimated at around 50%, although recent studies suggest this has increased substantially and, in some districts, is now around 65%. Rates of underweight are at 25% and acute wasting around 6%.
Issue 25, May 2005 (page 18)
This article describes the experience of local production of Ready to Use Therapeutic Food (RUTF) in Malawi by Valid Nutrition with regard to economic impact on local farmers.
Issue 38, April 2010 (page 18)
Summary of published research.
Issue 20, November 2003 (page 12)
Summary of workshop report.
Issue 38, April 2010 (page 22)
Therapeutic Feeding Centres (TFCs) are often highly effective in treating individual cases of severe malnutrition. Their exacting requirements for hygiene, and delivery of the medical and nutritional protocols means that they are often set up as 'parallel structures,' with little room for local Ministry of Health (MoH) involvement.
Supplement 2, November 2004 (page 51)
Somalia has been in a state of armed conflict since 1988, and has been without an effective government since the fall of Siad Barre in 1991, representing the longest case of state collapse in modern times.
Issue 43, July 2012 (page 28)
Kenya has a population of 38.7 million people, of which 5,939,308 are children under five (U5) years of age. The country is divided into eight provinces: Coast, Eastern, Central, North Eastern, Rift Valley, Nyanza, Western and Nairobi.
Issue 43, July 2012 (page 78)
This article describes the research findings1 of the first phase of a two-part study in Malawi by Valid International, which is exploring how existing CTC programmes can be adapted in the context of HIV/AIDS.
Issue 25, May 2005 (page 7)
This article describes the history of an international non-governmental organisation (INGO)-implemented programme that evolved from an innovative emergency intervention into a longer-term initiative, to support the Ministry of Health (MoH) to integrate treatment services for Severe Acute Malnutrition (SAM) within the routine health system.
Issue 40, February 2011 (page 69)
This article describes a pilot project by Concern Worldwide in Bardiya district, Nepal to integrate CMAM into routine health services directly, without the more typical transition from an NGO led programme.
Issue 39, September 2010 (page 33)
The management of severe acute malnutrition (SAM) has improved substantially in recent years. However, despite these improvements coverage remains shockingly low. There has been a realisation that treatment can only be achieved at scale by ensuring the availability of and access to treatment at all levels of the health system and community (task shifting).
Issue 43, July 2012 (page 62)
This supplement presents a collection of articles written by people who have been involved in Community-based Therapeutic Care (CTC) programmes.
Supplement 2, November 2004 (page 4)
Further to your article on the technical debate regarding the management of severe malnutrition, I wish to offer some contextual information to the development of the World Health Organisation (WHO) guidelines, and agency field protocols.
Issue 20, November 2003 (page 18)
Letters.
Issue 24, March 2005 (page 17)
Letter.
Issue 33, June 2008 (page 24)
MSF would like to thank Schofield et al for their constructive criticism in the letter section of the previous edition of Field Exchange.
Issue 15, April 2002 (page 9)
Revised MSF nutrition guidelines.
Issue 14, November 2001 (page 21)
First my gratefulness goes to Professor Michael Golden and Yvonne Grellety for their detailed and scientific article based on the research outcome of about 8500 children comparing the observed to expected mortality rate done in different therapeutic feeding institutions (Field exchange, issue 15, April 15, pp. 12-13).
Issue 16, August 2002 (page 20)
Summary of research.
Issue 43, July 2012 (page 37)
Summary of editorial.
Issue 37, November 2009 (page 8)
The French company, Nutriset, has been involved in projects aimed at establishing local production of Plumpy’nut - a ready-to-use food product (RTUF) employed in feeding programmes for the management of severe malnutrition.
Issue 20, November 2003 (page 14)
The development of RUTF has been an important factor facilitating the development of CTC. However at the moment, most RUTF is made in France, is marketed at a high cost and incurs considerable transport overheads to move it to the point of use.
Supplement 2, November 2004 (page 33)
For the past eight years, Fondation Terre des hommes (Fondation Tdh) have been working in Mauritania, opening a nutritional unit for managing acute malnutrition in 2000.
Issue 34, October 2008 (page 13)
This article describes some of the preliminary findings of a recent study that introduced locally produced Ready to Use Therapeutic Food (RUTF) into a hospital setting in Uganda, comparing its use to F100 during the rehabilitation phase. This article focuses particularly on the experiences producing local RUTF in a hospital setting, including cost comparisons with the routinely used F100.
Issue 28, July 2006 (page 22)
Marion Kelly summarised recent deliberations among NGOnut contributors in relation to the administration of iron (and folate) in malaria endemic areas. Below is her summary in point format. .
Issue 4, June 1998 (page 30)
Niger is a land-locked Sahelian country with a population of over 15 million people, of which approximately 50 per cent are children under 15 years of age. Niger ranks 173rd out of 177 countries according to the 2010 UNDP1 Human Development Index.
Issue 43, July 2012 (page 52)
Summary of evaluation.
Issue 43, July 2012 (page 83)
Summary of research.
Issue 34, October 2008 (page 7)
This article is based on a case study and presentation delivered by Biraj Patnaik for the Addis Ababa Conference on CMAM scale up in November 2011. He describes the scale of nutritional problems in India, current institutional mechanisms, and challenges in addressing the SAM burden in particular. Jamie Lee and Bernadette Feeney (Valid International) were invited by the India delegation to describe a number of developments in India since the conference around CMAM that are shared in a postscript.
Issue 43, July 2012 (page 85)
This article gives an overview of the coverage estimation method developed for the Community Therapeutic Care (CTC) Research Programme in Malawi.
Issue 21, March 2004 (page 11)
This article, provides an 'experience based' sequel to Field Exchange's analysis of the DPRK crisis (see issue 3). It casts doubt on claims of widespread malnutrition, focuses on the appalling state of care available to chronically malnourished children, and highlights the considerable operational difficulties in running nutritional programmes in DPRK.
Issue 5, October 1998 (page 21)
Summary of unpublished research.
Issue 22, July 2004 (page 10)
Summary of published research.
Issue 34, October 2008 (page 12)
Summary of internal evaluation by Anna Taylor (headquarters nutrition advisor for SC UK).
Issue 16, August 2002 (page 26)
International NGOs usually provide better treatment for children with severe malnutrition in their feeding centres than is provided by local hospitals.
Issue 17, November 2002 (page 22)
It is quite wrong to consider the advantage of F75 as “theoretical”.
Issue 15, April 2002 (page 12)
The manufacture of Ready to Use Food (RUTF) in developing countries, using ingredients purchased from local farmers, has always been a central element in the Community-based Therapeutic Care (CTC) model.
Issue 38, April 2010 (page 20)
Le Niger est un pays enclavé du Sahel, avec une population de plus de 15 millions de personnes, dont environ 50% sont des enfants de moins de 15 ans. Le Niger se classe au 173e rang sur 177 selon l’Indice de développement humain du PNUD 2010.
Issue 43, July 2012 (page 52)
Summary of research.
Issue 37, November 2009 (page 10)
Summary of published research.
Issue 39, September 2010 (page 19)
Summary of published letter.
Issue 8, November 1999 (page 8)
Since 1986, Nutriset has been very involved in seeking practical solutions for the development of quality nutritional products.
Issue 32, January 2008 (page 14)
Summary of research.
Issue 33, June 2008 (page 11)
Summary of meeting abstract.
Issue 34, October 2008 (page 10)
The Islamic Republic of Pakistan is the sixth most populous country in the world (>180 million in 2011), the second largest Muslim population after Indonesia and has wide diversity in terms of culture, ethnicity, language, geography and climate. Pakistan is a federal parliamentary republic consisting of four provinces and four federal territories.
Issue 43, July 2012 (page 67)
Centric Systematic Area Sampling (CSAS) was developed to estimate coverage of selective feeding programmes.
Issue 33, June 2008 (page 3)
The last fifteen years have seen unprecedented progress in the field of management of severe acute malnutrition (MSAM).
Issue 39, September 2010 (page 42)
In response to a food shortage in 2002, Concern Worldwide and Valid International piloted a Community-based Therapeutic Care (CTC) project in two districts in Malawi.
Issue 35, March 2009 (page 18)
Summary of proceedings.
Issue 38, April 2010 (page 17)
Routine prescription of antibiotics to all TFC admissions regardless of clinical presentation (as recommended by WHO protocol ) seems rather extreme. What are the benefits and risks involved?.
Issue 4, June 1998 (page 23)
Steve Collins recently drew attention to a situation in Haiti where the only food being used (i.e.,F100) in the treatment of severe malnutrition became unavailable. Health staff subsequently adopted dangerous treatment approaches (i.e., dextrose-saline drips) which resulted in higher mortality rates (>70%) amongst kwashiorkor patients.
Issue 4, June 1998 (page 30)
The article below highlights the difficulties of providing effective treatment for severe malnutrition in non-emergency situations within local health structures based on experiences in Malawi and Guinea.
Issue 17, November 2002 (page 20)
This article describes practical problems in preparing therapeutic milk in a hospital-based setting and makes some suggestions to resolve them.
Issue 32, January 2008 (page 13)
On going Research.
Issue 2, August 1997 (page 15)
This article presents Meds & Food for Kids, an independent local producer of therapeutic and supplementary foods in Haiti, and its pursuit of accreditation as a manufacturer of Ready to Use Therapeutic Food and acceptance in international supply chains. This story serves as a backdrop to a wider conversation on the viability of the national production model for Ready to Use Foods, and the obstacles and opportunities that are present for specialised manufacturing in developing world contexts.
Issue 39, September 2010 (page 10)
Following the CMAM mapping exercises of 2009 and 2011, UNICEF and Valid International are working together through a UNICEF-supported Project Cooperation Agreement (PCA). Thanks to Erin Boyd (UNICEF), Nicky Dent (Valid International),James Hedges (UNICEF HQ), Gideon Jones (Valid International), and Rachel Lozano for contributing to this article.
Issue 43, July 2012 (page 38)
Summary of publication.
Issue 37, November 2009 (page 13)
The ENN recently interviewed Steve Collins and Paul Murphy from Valid Nutrition (VN) at a Central London Hotel.
Issue 39, September 2010 (page 46)
In Ethiopia, 13.7 million people face chronic food insecurity. Out of this figure, the number of people who needed emergency food aid reached about 6.2 million in June 2009. An additional 7.5 million received aid in return for work on community projects as a part of the Productive Safety Net Programme (PSNP).
Issue 40, February 2011 (page 79)
World Vision Ethiopia (WVE) is a non-governmental organisation (NGO) that has been working in Ethiopia implementing crosssectoral relief, rehabilitation and development programmes since 1971.
Issue 40, February 2011 (page 53)