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Do you know where CHWs are conducting SAM treatment at a community level? Do you have any relevant resources that you can share?

This question was posted the Management of wasting/acute malnutrition forum area and has 11 replies.

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Natalie Sessions

CMAM Forum Coordinator

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3 Nov 2016, 16:31

Lynette Friedman and Cathy Wolfheim are currently compiling a report on the treatment of Severe Acute Malnutrition (SAM) by lay community-based providers in development contexts. Knowing that there is very little published research on this topic, we are reaching out to identify any country or program contexts that may have information to share related to SAM treatment at the community level.

This review was commissioned by the CMAM Forum, together with its broader Coalition, and aims to examine the factors that facilitate integrating SAM treatment into a CHW and/or iCCM model and identify criteria for countries considering implementing SAM treatment at the community level.

If you have any experience, program documents, or research reports to share, please forward them to or

Dr Charulatha Banerjee

Asia Regional Knowledge Management Specialist

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4 Nov 2016, 05:54

Dear Natalie,

This is one which comes immediately to mind done in Bangladesh. Take a look. Also please clarify what is your definition of a lay community based provider?


Natalie Sessions

CMAM Forum Coordinator

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4 Nov 2016, 10:43

Thanks so much Charulatha, this is exactly in line with what we are looking for. If you have any further resources on where community health workers are treating SAM at the community level and outcomes of this, it would be appreciated if you could share.


Nutrition expert

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4 Nov 2016, 10:49

ACF has experience in Mali and Bangladesh with the C-project ... you can contact them directly.

Tammam Ali Mohammed Ahmed

Nutrition Specialist/ Save the Children

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7 Nov 2016, 13:20

I think Comprehensive Community-Based Integrated Nutrition Programs(CCBINP) should host such activity to empower community health volunteers(CHVs) to deliver the OTP package in the second and third catchment areas( areas that are very far from the health facilities). CCBINP are not well established(still fragile) in terms of guideliens, protocols, and steps implementation as in Yemen

Ambarka Youssoufane

KM Specialist

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7 Nov 2016, 14:54

Dear Nathaly,

Here is an article from Field exchange about this subject in case you didn't come across.

Anonymous 635


Normal user

8 Nov 2016, 03:44

Save the Children had a pilot project here in District Swabi KP Pakistan, targeting children under 5 for SAM and CCM through LHWs (Lady Health Workers) with the theme activities of Essential Nutrition Actions (ENA) Framework

i had the experience of consultancy for training of MoH personnel from the filed who had supposed to provide the tackle down training to LHWs

Don't have further information related to impact or evidence generated or any study conducted
You may directly contact Save the Children for further assistance please

Anonymous 3211

Nutrition Officer

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8 Nov 2016, 04:24

Hi Natalie,
Partners in Health in Haiti (Zanmi Lasante) and the Children's Nutrition Program (Kore Timoun) also in Haiti both use community health workers to treat SAM in children under 5.

Anonymous 1310


Normal user

8 Nov 2016, 06:56

Hi all,

In Nepal, management of SAM is integrated with MOH system up-to community level .
Out-patient therapeutic program (OTP): Health post (HP) and sub-health posts (SHP) are located at community level (village development committee-VDC) as part of MOH system and OTP services are provided from those HPs/SHPs. Community medical assistant-CMA (trained on PHC course for 18 months) and health assistant-HA (trained on PHC/medicine course for 30-36 months) working in those HPs/SHPs are managing SAM children in those HPs/SHPs as per national CMAM guideline in addition to providing regular primary health care services.

Community Mobilization: There are female community health volunteers (FCHVs) in each village identified by MOH and they are doing screening, case findings and referral to HP/SHPs and follow up of malnourished cases at community level.

Thank you

Sansan Myint

UN REACH Facilitator, WFP

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8 Nov 2016, 11:04

The National Nutrition Center (NNC) under the Ministry of Health, Myanmar, with support from UNICEF, Myanmar, has completed an early first draft of the SAM/IMAM/CMAM treatment guidelines. This has not yet been shared with partners but the expectation is that it will be disseminated soon. UNICEF and the NNC will be convening a technical network meeting on 15th November UN REACH expects to get some updates on this and other work of partners. UN REACH will post updated information as things make progress on the SAM and IMAM Guidelines and other areas as well.


Project Manager Nutrition-Catholic Relief Services

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8 Nov 2016, 11:57

In Sierra Leone, Community Health Workers are community recruited personnel that support health facilities and the communities on voluntary basis, they are trained on basic malnutrition concept, how to use MUAC tape, how to carryout oedema test, and conduct active screening in catchment communities and refer children to OTP/IPF using the available referral package existing at the various district.

In S/Leone CHWs are also trained in some district on iCCM basic concept, to identify the three priority diseases : Malaria, Diarrhoea and Pnuemonia; and they give start dose treatment at community level base on age when identified; ACT for fever (malaria), Zinc 20mg for frequent waterish stool more than three times within 24 hours ( Diarrhoea), coughing for three days or more with cotrimoxaxole 120mg for Pnuemonia; and refer the child to health facilities for appropriate investigation and management if there is no development.

Natalie Sessions

CMAM Forum Coordinator

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10 Nov 2016, 14:40

Thank you so much for your input everyone, it is most appreciated! We are following up with the information you provided.
Estelle- would it be possible to provide a bit more detail on the work going on in Haiti? If possible, could you email me in relation to this-

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