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Post a reply: Treatment of SAM children in the absence of RUTFs

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In an area where there is targeted feeding programme for moderately undernourished children and PLW with supercereal plus and supercereal and oil respectively but no RUTF for SAM cases, what should be done? The current practice, I am referring to, is that children and PLW are screened in the community and those moderately undernourished are referred to the feeding center (government health care facilities) for their food rations and other services. The caretakers of those with SAM are advised to go to the hospital but of course many do not go! Could these children (SAM cases) be given the supplementary food rations if they are not taken to the hospital? Would this put them in greater risk? I am fully aware that it is not the appropriate food for them. But even when they go to the hospital, there are no RUTF and the health personnel in most cases are not trained in management of SAM. Communities of course do not understand why severe cases should be left out of the food rations and it is a problem for the Community Nutrition Workers who do house to house screening! There is a CMAM protocole endorsed by the government but the same government does not allow importation of RUTFs hence there are no RUTFs in health care facilities. RUTF for the country, from local food products, are still under development in collaboration with a research institute and UNICEF. Where some INGOs manage in a way to import RUTF and in areas where they operate (alone or with other partners) both MAM and SAM are being treated.
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