Research Snapshot: Simplifying acute malnutrition treatment in emergency settings

Tackling acute malnutrition is a global humanitarian priority. Two studies in Mali and Niger demonstrated that decentralisation of treatment to health post level, using a simplified-combined protocol, has the potential to increase treatment coverage and decrease costs of acute malnutrition treatment in humanitarian settings.

The standard protocol for acute malnutrition treatment means that treatment products and dosages differ between children with severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). This makes implementation of treatment complex. Additionally, in some settings, acute malnutrition is only treated at health facilities, with challenges for access. To address these challenges, humanitarian nutrition actors have been developing solutions that both simplify treatment and explore the use of community health workers (CHWs) to treat malnourished children who are currently hard to reach.

This research project comprised two studies, testing for the first time CHW-led treatment using a simplified-combined protocol in humanitarian settings. A 3-arm non-inferiority randomised controlled trial (RCT) was conducted in Gao, Mali, and a non-randomised trial conducted in Diffa, Niger. Findings from both locations indicate the approach is effective at treating acute malnutrition, and cost-effective, lowering costs and improving coverage. The use of a simplified- combined protocol could simplify implementation, reducing errors, costs and amounts of read-to-use therapeutic foods required to treat acute malnutrition. These results are relevant for humanitarian actors and governments focused on tackling malnutrition and improved support for community health workers.