Increasing Access to Community-based Management of Acute Malnutrition (CMAM) Programming


Severe acute malnutrition (SAM) affects about 17 million children under 5 globally. SAM is the most extreme and visible form of undernutrition; children in this condition are on the brink of starvation and require urgent treatment to survive. About 1 million children die each year from SAM and overall nutrition-related factors contribute to about 45% of all child deaths. Meanwhile, SAM is completely treatable and malnutrition is preventable. At the international level, there is agreement that the best standard of care for SAM is Community-based Management of Acute Malnutrition (CMAM) programming with Ready-to-Use Therapeutic Food (RUTF) treatment products; most countries globally have agreed upon this standard (with the notable exception of India). CMAM has expanded significantly in the last 10 years, and cure rates with treatment are about 90%. However, there are still several challenges that prevent scale-up of these programs to reach more children. (Only about 3 million children with SAM are treated each year).

Existing challenges include: coordination between international organizations and host governments, coordination among NGOs (with each other) and with host governments, coordination between donors and humanitarian partners, the relative high cost of treatment products, incomplete health service coverage in countries and regions, shortage of trained healthcare personnel, ability to locate and find cases, and shortage of funding for both treatment products and programs. In order to increase global CMAM coverage, it is important to identify which areas are most impactful and focus resources there.

All Rohingya refugees are in need comprehensive food security. Rakhine state has one of the highest malnutrition rates in Myanmar. People arriving in Bangladesh are already highly vulnerable and in need of emergency food and nutrition support. Up to 90% of new arrivals have reported eating just one meal a day, and do not have a sufficiently diverse food intake. The host community of Cox’s Bazar also experiences severe challenges accessing sufficient food with 57% of the population food insecure. Alarming food insecurity and malnutrition rates were extreme even before the influx: in Balukhali refugee camp, global acute malnutrition, stunting and underweight rates all exceeded WHO thresholds for nutritional emergency. Urgent nutrition needs have been prioritized for children aged under five (including infants), pregnant and lactating women and adolescent girls. These include close to 17,000 children under five suffering from severe acute malnutrition (SAM) to be supported over the next six months.