Integrated management of acute malnutrition in kenya. We applied qualitative methods to study the status of integration of acute malnutrition interventions in niger. Integrated management of acute malnutrition national guidelines. The government of nepal gon has strengthened its efforts to fight hunger since 2009, conscious of. Integrated management of acute malnutrition defined as the outpatient and inpatient management of severe acute malnutrition 3. Severe acute malnutrition remains a major killer of children under five years of age.
Integrated guidelines for the management of acute malnutrition. Gossmoh we thank the director of nutrition, ministry of health, government of southern sudan for permission to publish the ministrys interim guidelines on the integrated management of severe acute malnutrition. Malnutrition is the end result of chronic nutritional and, frequently. Management of severe and moderate acute malnutrition in. The training package is based on the 2002 world health organisation who training course on the management of severe. The integrated management of acute malnutrition national guidelines for health workers at the health facilities will be instrumental in building capacity of the. Interim guidelines on the integrated management of severe acute malnutrition authors. Communitybased management of severe acute malnutrition was.
Process a national consultative meeting on integrated management of severe acute malnutrition. It should integrate with community management therapeutic programs, and linkages with child treatment center, district hospitals and tertiary level centers offering inpatient management for sam. Utilization of imam services defined as a percentage of malnourished. National guideline for integrated management of acute malnutrition. Optimal maternal, infant and young child feeding and caring practices reduce underweight and stunting and set the foundations for appropriate growth. Management of severe and moderate acute malnutrition in children. Friedman school of nutrition science and policy, tufts university, boston, usa 3. For the purpose of this paper, integration was defined from a health system perspective as the extent, pattern and rate of adoption and assimilation of interventions for management of acute malnutrition into key functions of the national health system. Integrated management of acute malnutrition imam development of imam in kenya.
Moderate acute malnutrition severe acute malnutrition underweight 115125 mm 70 and may 17, 2018 imam stands for integrated management of acute malnutrition it is an integrated program to fight back against acute malnutrition. In children 6 months with acute diarrhea, zinc reduces duration of diarrhea by approximately 10 hours. As a result of this study the revised guideline for management of acute malnutrition called integrated management of acute malnutrition imam was drafted. Chapter five outpatient therapeutic care for the management of sam clients with no medical. A manual for physicians and other senior health workers, and the who is grateful to all those involved in the production of this fundamental training course. The guidelines were first applied by action contre le faim acf in 1994 in rwanda and. Imam stands for integrated management of acute malnutrition it is an integrated program to fight back against acute malnutrition. It also addresses management of moderate acute malnutrition and management of acute malnutrition in the context of hiv and aids.
Global acute malnutrition gam is the sum of moderate acute malnutrition mam and severe acute malnutrition sam. It is severe acute malnutrition if the wasting is severe wh pdf 38kb list of participants pdf 36kb who, unicef, fanta african regional training on integrated management of severe malnutrition dar es salaam, 20th to 30th september 2006. These cover all aspects of the modern management of acute malnutrition including community outreach, outpatient and inpatient care and monitoring and reporting. For clarity, this chapter refers to communitybased management as cmam. In 2016, 156 million children under5 suffered from stunting. The guideline will be complemented by training materials that give more explanation, exercises and examples of the management of acute malnutrition using the imam approach. World health organization integrated management of childhood. These guidelines have been developed in collaboration with partners based on the who guidelines and experience within and outside the country. Severe and moderate acute malnutrition can be successfully. That is, the medical problems of the child result, in part, from the social problems of the home in which the child lives.
Table 1 summarizes the components of integrated and standard protocols for the management of gam. The moh recognizes that timely and effective management of acute malnutrition in. Integrated community case management iccm is an integrated approach addressing disease and malnutrition through use of community health volunteers chvs in children under5 years. The sites were randomly assigned to deliver either integrated or standard management of acute malnutrition with the use of a randomnumber generator by a study aid without knowledge of the characteristics of study sites. Communitybased management of severe acute malnutrition can have a major public health impact with modern treatment regimens and improved access to treatment, casefatality rates can be as low as 5 per cent, both in the community and in healthcare facilities. Integrated and simplified approaches to community management. Integrated management of acute malnu trition imam was i nitiated in kenya in 2009 based on the cmam model. Who training course on the management of severe malnutrition. Severe malnutrition is both a medical and a social disorder.
Acute malnutrition may be classified as moderate or severe. These guidelines will also link to interventions taking place concerning infant and young child feeding. Our objective was to determine the recovery and coverage rates for gam of an integrated protocol with a single food. Coverage of integrated management of acute malnutrition. Acfin guidelines for the integrated management of sam legal information 3 legal information statement on the protocols on the management of severe malnutrition contained within this document are the of professor michael h golden and dr yvonne grellety. Kzn guidelines on the integrated management of acute. Interim guidelines on the integrated management of severe. Guidelines for management of acute malnutrition through communitybased therapeutic care ctc iii this protocol has been put together by the national communitybased therapeutic care programme taskforce, cofacilitated by the ministry of health and child welfare and unicef.
Integrated management of acute malnutrition guidelines author. In children with signs of moderate malnutrition the effect appears greater, reducing the duration of diarrhea by 27 hours. The guideline is structured to give a basic introduction and principles of the imam approach. The use of different foods and protocols for mam and sam treatment can be cumbersome in emergency settings. The national guideline for integrated management of acute malnutrition brings forth a new approach in the management of severe acute malnutrition for effective care and rehabilitation. Moderate acute malnutrition severe acute malnutrition underweight 115125 mm 70 and integrated management of acute malnutrition includes sam management as part of routine health and nutrition services at all levels updated and evidencebased treatment involves and relies on a strong community component. N pal integrated management of acute malnutrition imam. Life saving comprehensive nutrition response including integrated management of acute malnutrition in morang district is one of the projects in flood affected areas that has been running to address the immediate problem of acute and severe malnutrition. A participatory bottleneck analysis was performed to identify the root causes of suboptimal performance in the somalia integrated management of acute malnutrition imam. Life saving comprehensive nutrition response including. Average national acute malnutrition levels increased from 3.
Demand for imam as part of routine health services has increased due to its. However, it is possible to reduce mortality rates substantially by modifying treatment to take account of the physiological and metabolic changes that occur in cases of. National guideline for integrated management of acute. National interim guidelines for the management of acute malnutrition. Anthropometric measurement techniques, interpretation of anthropometric indicators, decisionmaking at a glance. Pdf golden mh grellety y, integrated management of acute. We thank the director of nutrition, ministry of health, government of southern sudan for permission to publish the ministrys interim guidelines on the integrated management of severe acute malnutrition. Integrated management of acute malnutrition imam training facilitators introduction anppcansom with the support of shf and somaliland ministry of health development is implementing a live saving nutrition projects aimed to provide integrated management and prevention of acute malnutrition in hargeisa, berbera, gabiley and zeila districts. Scope and purpose pdf 38kb list of participants pdf 36kb who, unicef, fanta african regional training on integrated management of severe malnutrition dar es salaam, 20th to 30th september 2006. It is severe acute malnutrition if the wasting is severe wh integrated management of acute malnutrition imam has been effective in treating sam cases in kenya. World health organization integrated management of.
Pdf on aug 1, 2011, michael golden and others published golden mh grellety y, integrated management of acute malnutrition imam generic protocol english version 6. Thus, integrated management of acute malnutrition imam in nepal was born. Integrated management of childhood illness imci sarah ashley, md. Integrating acute malnutrition interventions into national. Pdf on aug 1, 2011, michael golden and others published golden mh grellety y, integrated management of acute malnutrition imam generic protocol english version. It is severe acute malnutrition if the wasting is severe wh management of moderate acute malnutrition mam. The malawi inpatient management of severe acute malnutrition training package includes training modules, training guides, training aids, training planning tools, and job aids. The guidelines present the main body of the recommendations for the management of acute malnutrition, with explanations and following a logical order. Current knowledge and practice cmam forum technical brief. Jan 31, 2018 the guidelines for the integrated management of acute malnutrition imam of the ministry of public health moph public health directorate pnd are a tool to assist health agents managers and. Integrated management of acute malnutrition guidelines enn.
The survival of wasted children, however, depends on timely detection and management of moderate and severe malnutrition. Bottleneck analysis for the integrated management of acute. It is a nutritional program designed especially for children of 659 months of age and is a very important concept for management of malnutrition. Nutrition council snnc has developed national guidelines for management of severe and moderate acute malnutrition. Acute malnutrition defined using mid upper arm circumference of less than 12. Sam is defined by the presence of bilateral pitting oedema or. Communitybased treatment of malnutrition was initially referred to as the community therapeutic care model, but it may also be called community management of acute malnutrition cmam and integrated management of acute malnutrition. Protocol for the management of severe acute malnutrition. A working group was established under leadership of the public nutrition department and membership of several international and national. The guidelines for the integrated management of acute malnutrition imam of the ministry of public health moph public health directorate pnd are a tool to assist health agents managers and.
Consensus statement of the indian academy of pediatrics on. This evaluation case study report for integrated management of acute malnutrition imam in kenya was commissioned by the unicef evaluation office eo as part of a global evaluation of community management of acute malnutrition cmam that includes examining unicef s programme. Recognition and management of malnutrition 8 daniel martinezgarcia md laurent hiffler,md teresa m. Imam programming started in earnest during 2007 when the moh, unicef and who entered into a tripartite agreement to respond to the varied and complex crises that kenya regularly faces. Iycf, micronutrients and the integrated management of. The guidelines for the integrated management of acute malnutrition imam of the ministry of public health moph public health directorate. About 55 million children are wasted, of whom 19 million have severe acute malnutrition. Among several programs to enhance nutritional progress, imam has been very successful in preventing and treating the cases of malnutrition. This technical brief is one of three commissioned by the communitybased management of acute malnutrition cmam forum. Diagnosis of acute malnutrition integrated management of.
Evidence on the potential impact and practical experiences on integrating communitybased management of acute malnutrition as part of an iccm package is not. Training course on impatient management of severe acute. Hence the shift to the term integrated management of acute malnutrition imam. Acknowledgements this inpatient management of children with severe acute malnutrition sam training course is the practical application of the 1999 world health organisation who publication management of severe malnutrition. Integrated management of acute malnutrition guidelines. Acute malnutrition is classified into severe acute malnutrition1 sam and moderate acute malnutrition mam according to the degree of wasting and the presence of oedema. Imam integrated management of acute malnutrition imci integrated management of childhood illness iycf infant and young child feeding lbw low birth weight lmic low and middleincome countries lns lipidbased nutritional supplements lrti lower respiratory tract infection mam moderate acute malnutrition. Results showed that levels of acute malnutrition were poor to serious, with the global acute malnutrition gam rate ranging from 5% to 17% in selected districts. Management of sam should not be a stand alone program. The brief focuses on current principles and approaches to moderate acute malnutrition mam management, highlighting key constraints, gaps in knowledge and areas still lacking consensus. Key messages of imam integrated management of acute. Acute malnutrition l evels in keny a remain unacceptably high. Integrated management of acute malnutrition imam training. Guideline for integrated management of acute malnutrition.
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