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Admission criteria MUAC under 115 mm and RUTF shorfall in SC nutrition program in Burkina

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 2 replies. You can also reply via email – be sure to leave the subject unchanged.

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Jean NADEMBEGA

Nutrition Program Manager / Save the Children Ca

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21 Jul 2011, 12:49

save the Children in Burkina Faso is running a CMAM program since 2008 in partnership with MoH and UNICEF for RUTF supply and therapeutic milk. Their are not food distribution and MAM receive systematic treatment including deworming and micronutrients, free medical treatment and mothers receive educations. A stabilisation center in the regional hospital, OPT in 52 HC and door to door screening in villages every two monthly. Rejections have start discuraging mothers referred by HW but since we start using the new admission criterias (MUAC under 115 mm), the HWs have received more confidence from the mothers and admissions have signifiquently incruised and we are face to a shortfall of RUTF. UNICEF and Nutrition Director who encuraged us to engage in are no longer capable to supply the district enough with the quantity of RUTF planned for the year 2011. They recently supplied us with less of our need in July.

A new program to free treatment for all children under 5 started in the district and we expect more children specifically during the rainy season. This would probably reduce new cases. The MAM cases have reduced due to the extend of admission criteria to MUAC <115 mm.

One of solution we have already taken is to stop the take home at the end of the treatment and appropriate follow up to reduce the non responses due to absences or defautlters. What other action can be done to mitigate the issue of the unsuffisent RUTF due to MUAC <115 mm criteria?
NB: The Moh have not yet adopted the new norm of WHO but it includes in the new training manual.

Anne Walsh

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22 Jul 2011, 11:47

Stopping the takehome at the end of treatment is a good move. The best takehome ration on discharge is giving 7 packets - one packet per day as they wean off the RUTF.

How long are children staying in the programme, and what discharge criteria are you using? If weight gains are slow then a way to try and reduce the RUTF consumption is to focus on reducing sharing,therefore faster recovery and shorter length of stay in the programme.

Is there any BP100 available? If there is you could do a mixed RUTF/BP100 ration for children >1 year (so that the BP100 can be eaten as a biscuit not as a porridge.

The only other solution I can think of is to stay with 11cm cut off until the RUTF needs can be met. But this will mean extensive communication with HWs and communities so that the reason for going back to 11cm is fully understood. But 11.5cm is much better than 11cm, so make sure everyone is advocating loudly for an increase in RUTF allocations.

Jean NADEMBEGA

Nutrition Program Manager / Save the Children Ca

Normal user

30 Aug 2011, 23:09

Thank you very for your reply and advices. We have been suplied by UNICEF so, we staid with the MUAC 115 mm, reduced the take away, sensitized more on the sharing.

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