Models for Strengthening the Community-based Management of Acute Malnutrition_Hedwig Deconinck_5.6.14
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The document discusses the CMAM (Community-based Management of Acute Malnutrition) Forum, a multi-stakeholder initiative to improve health outcomes through improved information sharing about managing acute malnutrition interventions worldwide. The CMAM Forum aims to provide easy access to technical guidance, evidence, and learning from nutrition and health actors through an open access interactive website. It also seeks to develop technical materials to address information gaps and assess the effectiveness of the CMAM Forum through case studies in 4 countries. The overall goal is to support quality improvement, integration and scale-up of acute malnutrition management.
Models for Strengthening the Community-based Management of Acute Malnutrition_Hedwig Deconinck_5.6.14
- 1. www.cmamforum.org cmamforum@gmail.com Collaborating to improve the management of acute malnutrition worldwide COREGroup, Silver Spring, May 6, 2014 Information-sharing to improve learning about community-based management of acute malnutrition and its impact
- 2. www.cmamforum.org cmamforum@gmail.com 2 Supplementary feeding for the mgmt of MAM/ malnutrition Inpatient mgmt of SAM Management of acute malnutrition before 2000 CURATIVE AND PREVENTIVE HEALTH PREVENTIVE NUTRITION CURATIVE NUTRITION
- 3. www.cmamforum.org cmamforum@gmail.com 3 Community outreach: Early case detection and community engagement Outpatient mgmt of MAM Inpatient mgmt of SAM Outpatient mgmt of SAM RUTF Management of acute malnutrition from 2000 on CURATIVE AND PREVENTIVE HEALTH PREVENTIVE NUTRITION CURATIVE NUTRITION
- 4. www.cmamforum.org cmamforum@gmail.com 4 IMCI Community Outreach: Early case detection and community engagement Outpatient mgmt of MAM Inpatient mgmt of SAM Outpatient mgmt of SAM CURATIVE AND PREVENTIVE HEALTH AND NUTRITION National production of RUTF + CMAM approach Food security Social safety nets WASH Education Gender IYCF - ENA
- 5. 5 El Fasher Um Keddada Mellit Kutum Taweisha El Laeit Malha Tawila & Dar el Saalam Karnoi & Um Barow Koma KormaSerif Kebkabiya Fata Barno Tina N. Darfur 2001 Hospital with inpatient care El Sayah Outpatient care site 100 kms Inpatient care site
- 6. www.cmamforum.org cmamforum@gmail.com Global burden of acute malnutrition Source: ACF 2014
- 7. www.cmamforum.org cmamforum@gmail.com CMAM at scale since 2007 60 countries with CMAM (2012)
- 8. Coverage of management of SAM 0 5000000 10000000 15000000 20000000 25000000 2009 2011 1,961,72 1,035, ? 2012 # Countries Admissions Expected Coverage East Asia Pacific 10 31,813 2,231,020 1% East & South Africa 18 890,414 2,987,674 30% America & Caribbean 3 28,882 255,636 11% South Asia 7 258,366 21,999,552 1% West & Central Africa 19 1,235,302 5,353,337 23% 63 2,662,712 34,692,340 8% 2.6 million children with SAM admitted for treatment out of an estimated 34.6 million (about 8%) Source: UNICEF 2013
- 9. Integration of management of SAM CMAM in 2012 (N: 62) YES PARTIAL NO N/A Management of SAM in national MCHN policy 50 9 3 0 Funds for SAM in annual health sector plan 24 0 35 3 SAM included in costed nutrition plan 39 0 23 0 RUTF on essential supplies list 21 0 41 0 Minimum one acute malnutrition indicator in HNIS 41 0 21 0 Management of SAM included in basic package of health services 19 31 12 0 Management of SAM as part of M&E and supervision 19 0 43 0 SAM screening in basic package of health services 24 29 9 0 Management of SAM in curricula for clinical health professions 24 0 38 0 Management of SAM in curriculum for health workers 27 21 14 0 Source: UNICEF 2013
- 10. www.cmamforum.org cmamforum@gmail.com Information access issues: Inconsistent and ad hoc information sharing and learning No one repository for resources Expressed needs: Sharing promising practices and evidence Learning from new contexts and innovative strategies that address challenges Improving access to up-to-date, practical, accessible information Identifying knowledge gaps Avoiding duplication Challenges for integration and scale up
- 11. www.cmamforum.org cmamforum@gmail.com CMAM Forum Multi-stakeholder initiative to improve health outcomes through: Improved information-sharing to support quality improvement, integration and scale-up of management of acute malnutrition interventions Easy access to technical guidance, evidence and learning from nutrition and health actors Relevant to WHA 2012 Resolution, Target 6: By 2025, reduce and maintain childhood wasting to less than 5%
- 12. www.cmamforum.org cmamforum@gmail.com Steering Committee Represents different sectors: Government: MOH Bolivia, Kenya, Malawi, Niger (Asia pending) UN agencies: FAO, GNC, UNICEF, UNSCN, WFP, WHO NGOs: ACF, Concern Worldwide, Save the Children Technical entities: ENN, FANTA, icddr,b, IMTF, Valid International Academic and professional associations (under discussion)
- 13. www.cmamforum.org cmamforum@gmail.com 1. Facilitate sharing of information and experience and capitalise on lessons learned Open access interactive website (library, country-specific resources, technical summaries and updates, training and audio-visual materials, advocacy resources, ongoing research summary, website links) 2. Develop technical materials to meet identified information gaps Technical summaries (technical briefs, FAQs, mapping, updates) CMAM Forum objectives
- 14. www.cmamforum.org cmamforum@gmail.com 3. Assess effectiveness via case studies in 4 countries How CMAM Forum is used and how it can be improved to better strengthen quality and scale-up 4. Promote/support a harmonised advocacy strategy: Positioning AM as a major health and nutrition priority, ensuring issues are raised, articulated, shared For example the “Generation Nutrition” ACF Campaign CMAM Forum objectives (continued)
- 17. www.cmamforum.org cmamforum@gmail.com Assessing the effectiveness: M&E • Information products and services • Audience: members or users • Reach: breadth and saturation of dissemination • Usefulness: user satisfaction and quality • Use: What is done with knowledge gained
- 18. Adapted from: Sullivan T et al. 2007. Guide to Monitoring and Evaluating Health Information Products and Services. Washington, DC: USAID. M&E conceptual framework
- 19. M&E methods Routine monitoring (at global and country level) Website statistics on website usage In-depth studies (at global and country level): Global member and user e-surveys Country case studies (India, Kenya, Niger, Yemen): member e-survey, KII, FGD Mid-term review Evaluation
- 20. www.cmamforum.org cmamforum@gmail.com Routine monitoring: website usage • Over 1,400 members from 88 countries (100-150 new members per month) • Two-thirds of members are from low-income countries • Over 10,000 website visits per months • 20% of website visits from French speaking countries • 8% of resources in French, 1% in Spanish, and < 1% in Arabic
- 21. www.cmamforum.org cmamforum@gmail.com Trends (July 2012–March 2014)
- 22. www.cmamforum.org cmamforum@gmail.com Membership profile Education background: Nutrition-dietetics 52%, medicine 16%, nursing 6%, social-community development 4%, other 13%, unknown 8%
- 23. www.cmamforum.org cmamforum@gmail.com • Ways for expanding the audience • Improving national information sharing • Guidance to key resources • Topics for technical summaries • e-Learning courses, podcasts by experts • Online social networking services • “Share” link • Arabic and French resources • Culturally adapted audio-visual resources Suggestions for improving (CCSs)
- 24. www.cmamforum.org cmamforum@gmail.com CMAM Forum First phase: Start-up (September 2011–December 2012) Second phase: Consolidation and expansion (January 2013– December 2014)
- 25. www.cmamforum.org cmamforum@gmail.com Join! Share! Contribute! Feed back! THANK YOU www.cmamforum.org cmamforum@gmail.com Collaborating to improve the management of acute malnutrition worldwide