Severe and moderate acute malnutrition can be successfully. Integrated management of acute malnutrition 2 this protocol on the integrated management of acute malnutrition was prepared by the national nutrition agency and the. In ethiopia, there are no national guidelines on acute malnutrition management for this age. Severe acute malnutrition globally, more than 29 million children under the age of 5 years, an estimated 5 percent, suffer from severe acute malnutrition sam 1, 2. National guideline for integrated management of acute malnutrition. 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. As a result of this study the revised guideline for management of acute malnutrition called integrated management of acute malnutrition imam was drafted. Management of moderate acute malnutrition immam as commissioned by wfp. A national consultative meeting on integrated management of severe acute malnutrition was held in mumbai on 16th and 17th october, 2010. Community outreach is critical in the management of acute malnutrition because of its focus on stimulating the understanding, engagement, and participation of communities in the prevention, identification, and treatment of acute malnutrition. Integrated management of acute malnutrition imam training. International guidelines for the integrated management of severe acute malnutrition.
The guidelines were first applied by action contre le faim acf in 1994 in rwanda and. Guidelines for integrated management of acute malnutrition in uganda iii list of tables table 1. Ethiopia sets new standards for the management of acute. The guideline replaces the 2007 protocol for management of acute malnutrition, and is based on the 20 who global recommendation for the 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. Utilization of imam services defined as a percentage of malnourished. It also addresses management of moderate acute malnutrition and management of acute malnutrition in the context of hiv and aids. Dec 24, 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. Guidelines for integrated management of acute malnutrition in. The subcounty has 12 health facilities whose staff are trained in imam. In march 2010, the moh launched the integrated management of acute malnutrition imam. Therapeutic feeding approaches in the management of severe acute malnutrition in children who are 659 months of age 36 6. Integrated guidelines for the management of acute malnutrition. This 2012 booklet combines the updated national guidelines into one easy to use tool for health providers.
It is severe acute malnutrition if the wasting is severe wh integrated management of severe acute malnutrition. Ethiopia sets new standards for the management of acute malnutrition. Summary for the classification of acute malnutrition table 3. S amir dalwai, p anna choudhury, s andeep b b avdekar, r upal dalal, u mesh kapil, ap d ubey, d eepak ugra, m anohar a gnani and hps s achdev correspondence. 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. Bottleneck analysis for the integrated management of acute. Nutrition council snnc has developed national guidelines for management of severe and moderate acute malnutrition. The national guideline for integrated management of acute malnutrition was developed as a tool to assist health workers in the assessment and appropriate management with services andor counselling for the treatment both moderate acute malnutrition mam and severe acute malnutrition sam. 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. The imam approach is a comprehensive strategy which combines and links inpatienttreatment severe with. One example of guidelines recently developed is the global nutrition cluster. Acute malnutrition defined using mid upper arm circumference of less than 12. National guideline for integrated management of acute. Integrated management of acute malnutrition imam including one stabilization center sigor subcounty hospital.
May 17, 2018 imam stands for i ntegrated m anagement of a cute m alnutrition. National interim guidelines for the management of acute malnutrition. In many health facilities the mortality rate from severe malnutrition is at present over 20%. For consideration, all applications should be accompanied by the following documentation. The imam approach is a comprehensive strategy which combines and links inpatient treatment severe. Semi quantitative evaluation of access and coverage squeac. Pdf golden mh grellety y, integrated management of acute. Scale up of integrated management of acute malnutrition in. Severe acute malnutrition sam is a major public health issue. Protocol for the management of severe acute malnutrition. Communitybased management of severe acute malnutrition was. It is a nutritional program designed especially for children of 659 months of age and is a very important concept for management of malnutrition. Vitamin a supplementation in the treatment of children with severe acute malnutrition 31 5.
National consultant on integrated management of acute. The resulting document combined existing guidelines with communit therapeutic care ctc and integrated aspects of treatment of malnourished hivaids. 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. Therefore, the management of mm should be a public health priority. It is defined by oedema bilateral pitting oedema, also known as nutritional oedema, kwashiorkor or oedematous malnutrition, is a sign bilateral pitting oedema of the feet, verified when thumb pressure applied on top of both feet for 3 seconds leaves a pit indentation in the foot after the thumb is lifted. Key messages of imam integrated management of acute. Use of antibiotics in the management of children with severe acute malnutrition in outpatient care 26 4. Management of severe acute malnutrition world health organization.
Integrated management of acute malnutrition patient. Management of severe and moderate acute malnutrition in children. It also addresses management of moderate acute malnutrition and management of acute malnutrition. From 1996 onwards, multiple interventions strengthened the management of acute malnutrition in afghanistan. Pdf on aug 1, 2011, michael golden and others published golden mh grellety y, integrated management of acute malnutrition imam generic protocol. Grellety developed the original guidelines on the integrated.
Coverage of integrated management of acute malnutrition. Impact health organization iho implements the integrated communitybased management of severe acute malnutrition in children under five years in magwi county eastern equatoria state with support from unicef south sudan. Integrated management of acute malnutrition national guidelines. Applications without proper position title or duty station reference will not be considered. The new guideline was launched on june 25th, 2019 by dr lia kebede, state minister of the federal ministry of health, who noted that nutrition is now getting the attention it deserves. A technical brief that focuses on current principles and approaches to moderate acute malnutrition mam management, highlighting key constraints, gaps in knowledge and areas still lacking consensus. Integrated management of acute malnutrition in uganda.
Integrated management of acute malnutrition international consultant kabul, clearly indicating position title and reference in the email title. Integrated communitybased management of severe acute. Integrated management of acute malnutrition fchv training. Iycf, micronutrients and the integrated management of childhood illness imci. Diagnosis and treatment plan for children 659 months of age. Gam recovery in the integrated management protocol was 910 of 1100 83% children and was 682 of 857 79% children in the standard therapy protocol. The launching ceremony in addis ababa was attended by government officials from federal and regional health bureaus, ngos, the donor community and representatives from. Guidelines for the integrated management of severe acute malnutrition. Acute malnutrition hits record levels in yemen with a devastating toll on children under five overview how severe, how many and when. National guidelines for the management of acute malnutrition among children under five and pregnant and lactating women acute malnutrition wasting andor oedematous malnutrition defined as muac acute malnutrition maybe moderate mam or severe sam. Integrated management of acute malnutrition in uganda 2010 resource type. Protocol and guidelines have been developed specifically for the myanmar. Integrated management of acute malnutrition free download as word doc.
Routine medications for all patients in sf programme table 4. The guidelines were first applied by action contre le faim acf in 1994 in rwanda and subsequently applied in many emergency situations. The communitybased management of acute malnutrition cmam forum. However, an integrated approach to optimizing healthy growth in infants and children. The resulting document combined existing guidelines with communit therapeutic care ctc and integrated aspects of treatment of malnourished hiv aids. The integrated management of acute malnutrition, and especially the management of severe acute malnutrition, is one of the key evidencebased nutrition interventions identified in the 2008 lancet series on maternal and child undernutrition. The integrated management of acute malnutrition imam is a strategy that combines and links inpatient treatment of malnourished children those with complications with outpatient care severe without complications also management of moderate malnourished children where. The national guideline for integrated management of acute malnutrition is intended for use by health managers, clinicians, nutritionists and community workers supported by the required level of training and with adequate resources to perform the activities and deliver treatment in a safe and effective manner. The manual for the management of mam completes the set of guidelines for acute malnutrition, which also comprises the national guidelines for the management of acute malnutrition for children under 5 years administrative order 20150055, and the national guidelines for the management of severe acute malnutrition sam. It is an integrated program to fight back against acute malnutrition. Inpatient and outpatient management of acute malnutrition. Management of moderate malnutrition in under5 children by. We launched the first ever food and nutrition policy in 2018, and today we are gathered here for another very important milestone, to.
Who established guidelines for the treatment of severe acute malnutrition. The moh recognizes that timely and effective management of acute malnutrition in. Acute malnutrition often referred to as wasting is a major global health problem. The integrated management of acute malnutrition national guidelines for health workers at the health facilities will be instrumental in building capacity of the. Integrated management of acute malnutrition defined as the outpatient and inpatient management of severe acute malnutrition 3. Integrated management of acute malnutrition ministry of.
Sam is associated with a mortality risk nine times higher than that of a nonmalnourished child, and among children with moderate acute malnutrition. Severe acute malnutrition sam is defined as a weightforheight measurement of 70% or less below the median, or three sd or more below the mean national centre for health statistics reference. These guidelines have been developed in collaboration with partners based on the who guidelines and experience within and outside the country. However, due to the unavailability of essential commodities readytouse therapeutic food rutf, f75 and f100 in the country, procurement concerns by the doh, and lack of a defined operational component in. Although there are lot of technical knowledge and skills required to implement this program effectively, in this article we will only guide you throughout the key messages and knowledge related to it. Severe acute malnutrition remains a major killer of children under five years of age.
Evidence on the potential impact and practical experiences on integrating communitybased management of acute malnutrition as part of an iccm package is not. National guidelines for the management of acute malnutrition. Integrated community case management iccm is an integrated approach addressing disease and malnutrition through use of community health volunteers chvs in children under5 years. A working group was established under leadership of the public nutrition department and membership of several international and national. Kzn guidelines on the integrated management of acute. However, due to the unavailability of essential commodities readytouse therapeutic food rutf, f75 and f100 in the country, procurement concerns by the doh, and lack of a defined operational component in the pimam protocols, the. The study authors therefore concluded that integrated management of gam in children is an acceptable alternative to standard management and provides greater community coverage. It was attended by the invited experts in the field.
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