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RUTF/RUSF dose per child

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 3 replies. You can also reply via email – be sure to leave the subject unchanged.

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Nitsuh Fikir

Public Health

Normal user

27 Oct 2016, 13:11

In the CMAM toolkit, Tool 4 (Supply Needs Estimation) excel sheet, the calculation for RUTF supply is made based on 80 sachet/child and for RUSF 168 sachets/child. I would like to know how the doses for RUTF and RUSF per child was estimated?

If we consider 8 weeks as an ALS for SAM child, then 80 sachet is very less (minimum number of sachets per child per week is 14). Similarly, if we consider a MAM child to stay 3 months in TSFP and we give him/her 1 sachet per day as per the available guidelines, then we need 90 sachets. 168 sachets per child for MAM looks very high.

Appreciate your thoughts

Paul

Normal user

24 Nov 2016, 13:49

Dear Nitsuh,

Thanks for raising the issue of RUTF/RUSF dosage as per Tool 4 (Supply Needs Estimation) of the CMAM Toolkit. It is a timely question/comment as the Toolkit is currently undergoing revision. Over the past few months, we’ve been collecting feedback from CMAM practitioners and very useful suggestions have come through, including some on the supply needs estimation. We have since established a multi-agency Technical Advisory Group to spearhead the revision process and we hope to finalize by the end of March 2017.

On this particular question referencing RUTF/RUSF dosage per child; the Toolkit falls short of clarifying that the calculator is generally for planning purposes and thus should be adapted to the context one is working in. The specific cells you refer to (80 for RUTF and 160 for RUSF) – are arbitrary figures and should be adjusted accordingly to reflect what is generally accepted or used in your context as quantity/dosage per child, when planning. However, one can only be able do so after downloading the calculator, something that needs more clarity in the instructions tab. For instance, most implementers use 136 sachets of RUTF per child + 10%, amounting to 150 sachets (one carton) for planning purposes. For RUSF, you may find this document by WFP useful: http://documents.wfp.org/stellent/groups/public/documents/manual_guide_proced/wfp281200.pdf

We will be very glad to hear any additional thoughts you may have regarding the Toolkit. Please feel free to reach out through cmamtoolkit@savechildren.org.

Nitush Fikir

Nutritionist

Normal user

5 Jan 2017, 12:03

Dear Paul,

Thank you very much for your guidance.

Wisdom

Normal user

5 Jan 2017, 16:24

A happy new-year to all!

I wish to point out that it would be important to consider application of objective measures/tools/applications when it comes to supply planning and dosages for malnutrition commodities i.e RUTF/RUSF as in the current case.

Quantimed and Pipeline are available tools which one can apply. These use either the morbidity method or the consumption method to objectively forecast the supply and dosages required.

Hope the above highlights on a potential method that could be considered.

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