Community-based Management of Acute Malnutrition
The Community-Based Management of Acute Malnutrition (CMAM) approach enables community volunteers to identify and initiate treatment for children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition in the home using Ready-to-Use-Therapeutic-Foods (RUTF) and routine medical care. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programmes also work to integrate treatment with a variety of other longer-term interventions. These are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.
The CMAM model was developed by Valid International and has been endorsed by WHO and UNICEF. CMAM was originally designed for the emergency context, as an alternative to the traditional model of rehabilitating all severely malnourished children through in-patient care at Therapeutic Feeding Centres. However, it is increasingly being implemented in the context of long-term development programming, with several Ministries of Health including components of CMAM in their routine services.
CMAM has been implemented around the world by many governments and NGOs. World Vision’s first CMAM project started in Niger in 2006. Since then, World Vision's CMAM programming has expanded to 15 countries.
CMAM should be implemented in any area where at least 10% of children under 5 are moderately malnourished (low weight for height) and there are aggravating factors present. Aggravating factors include generalised food insecurity, widespread communicable diseases and high crude death rate. The NCOE's Measuring and Promoting Child Growth tool explains how to accurately weigh and measure children.
CMAM targets children under 5 years old and their families, but the whole community is involved. Community leaders, volunteers, health staff and families participate in the screening, care and follow-up of children with acute malnutrition. Everybody celebrates as the children enrolled in the CMAM programme gain weight and enjoy better health.