Community Management of Acute Malnutrition (CMAM)

Early detection, timely referral, and sustained recovery for children with severe and moderate acute malnutrition.

OVERVIEW

Acute malnutrition remains one of the leading causes of illness and death among children under five, particularly in fragile and conflict-affected settings. The GIMPACS CMAM Programme ensures early detection, timely referral, quality treatment support, and sustained recovery for children with Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), working closely with Ministries of Health, Primary Health Care Development Agencies, and community structures.

The programme aligns with the National CMAM Guidelines, WHO wasting guidelines, the UNICEF CMAM Framework, and SDG 2 (Zero Hunger).

Strategic Objectives

Improve early identification and management of acute malnutrition among children under five and other vulnerable populations.
Increase access to quality community-based treatment and referral services for SAM and MAM cases.
Strengthen community participation in preventing, detecting, and responding to acute malnutrition.
Improve treatment adherence, recovery rates, and continuity of care through community follow-up.
Enhance caregiver knowledge and practices on nutrition, feeding, hygiene, and health-seeking behaviours.
Strengthen government and community systems for sustainable CMAM implementation.

Implementation Strategies and Approaches

Active Case Finding

Strategy: Strengthen community-based systems for early identification of children and pregnant/lactating women at risk of acute malnutrition.

Our Approach:

Train Community Health Volunteers and Mother-to-Mother Support Groups to identify early signs using national protocols.
Conduct routine household visits, outreach sessions, child health days, and immunization campaigns.
Prioritize hard-to-reach, conflict-affected, displaced, and nomadic communities.
Promote the Family MUAC approach so caregivers can identify malnutrition early.

MUAC Screening

Strategy: Promote routine, standardized nutrition screening to enable early detection and timely referral.

Our Approach:

Conduct regular MUAC screening for children aged 6–59 months and pregnant/lactating women.
Combine MUAC with oedema assessment and clinical observation per national CMAM protocols.
Integrate screening into immunization, antenatal/postnatal clinics, and outreach services.
Build the capacity of caregivers and volunteers to use MUAC tapes correctly.

Referral for SAM and MAM Treatment

Strategy: Ensure every identified child receives timely, uninterrupted treatment through a functional referral system.

Our Approach:

Establish standardized referral protocols linking communities to OTP, TSFP, Stabilization Centres, and PHC facilities.
Provide referral slips and clear counselling to caregivers on available services.
Support transportation and community escort mechanisms where feasible.
Track referral completion through community volunteers and facility feedback.

Treatment Support and Follow-Up

Strategy: Promote sustained recovery and prevent relapse through structured community follow-up and continuity of care.

Our Approach:

Conduct scheduled home visits to monitor children’s nutritional recovery after discharge.
Assess treatment adherence, weight gain, and household nutrition conditions.
Provide continued counselling on IYCF, hygiene, and dietary diversity.
Link recovered households to livelihood, home gardening, and food security support.

Community Mobilization

Strategy: Strengthen community ownership and participation in preventing and managing acute malnutrition.

Our Approach:

Work with traditional leaders, religious leaders, women’s associations, and youth groups to raise awareness.
Conduct community dialogue sessions to address myths, misconceptions, and stigma.
Establish and support Mother-to-Mother Support Groups for peer learning.
Engage men and household decision-makers to improve family support for child nutrition.

Nutrition Education for Caregivers

Strategy: Empower caregivers with the knowledge and confidence to prevent malnutrition and support healthy growth.

Our Approach:

Deliver individual counselling, household visits, and caregiver group demonstrations.
Provide practical guidance on breastfeeding, complementary feeding, and dietary diversity.
Demonstrate preparing nutritious meals using affordable, locally available foods.
Educate on hygiene, safe food preparation, and recognizing danger signs of malnutrition.

Cross-Cutting Implementation Approaches

Community-Based Programming: communities lead screening, referral, follow-up and nutrition promotion for lasting ownership.
Health Systems Strengthening: GIMPACS works through existing government systems rather than parallel structures.
Integrated Service Delivery: CMAM is linked with maternal and child health, IYCF, immunization, WASH and protection.
Equity, Inclusion and Gender Responsiveness: services reach children with disabilities, IDPs, host communities and remote populations.
Localization and Partnership: close collaboration with government health authorities, UNICEF, WFP and local NGOs.
Accountability to Affected Populations: feedback and complaints mechanisms are built into implementation.

Expected Outcomes

Through the Community Management of Acute Malnutrition (CMAM) Programme, GIMPACS aims to achieve:

Increased early identification and referral of children with acute malnutrition.
Improved access to quality treatment for SAM and MAM cases.
Higher recovery rates and reduced default and relapse rates among CMAM beneficiaries.
Strengthened caregiver knowledge and adoption of optimal nutrition practices.
Stronger referral systems and coordination between communities and health facilities.
Reduced morbidity and mortality associated with acute malnutrition.

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