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When to stop admitting children if a CMAM programme closing

This question was posted the Management of wasting/acute malnutrition forum area and has 4 replies.

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Alison Donnelly

Normal user

22 Mar 2012, 08:11

We have an emergency CMAM programme due to close next month and while the MOH have been trained to deliver CMAM, they will not receive RUTF from UNICEF and the reality is that there will be little options for treatment and follow up once we leave. Our feeling is that if an acutely malnourished child arrives on the final day of the programme, we admit them, then just provide a month's supply of RUTF as this is better than leaving them with no treatment at all. However, others stop admissions 2 months before the close of the programme to ensure that all children admitted have a chance of being fully cured. Is it acceptable to keep admitting right up until the close of the programme? If so, how should these children be recorded? Non-recovered or discharged cured or just remaining in the programme?

Anonymous 635


Normal user

22 Mar 2012, 11:26

I think it is not ethically sound that you stop new admissions before closing of the project while you have malnourished children. Instead of stopping admissions it is good that you provide 1 month prior supplies to the newly admitted children instead of leaving so

Anonymous 1324

Nutrition Officer

Normal user

22 Mar 2012, 11:39

Ideally an exit strategy should be integrated into any program plan for CMAM, especially if it is being done as an emergency intervention. If children are being admitted based on active screening then one strategy is to stop screening (and hence admitting) a certain time before program closure, depending on average length of stay perhaps, in order to minimize the number of children in program and the new admissions around the time of closure. In your case, then there isn't really much choice but to give complete rations with appropriate counseling. They shouldn't be recorded as non-recovered or cured because technically they are not discharges and should not be a factor in determining your program indicators.

Anonymous 81

Public Health Nutritionist

Normal user

22 Mar 2012, 13:45

Dear Anonymous 520, I totally agree with your decision. Go ahead admitting cases up to the end of 11 hours. one month supply of RUTF is very roughly equal to 50% of total ration (total duration).

Anonymous 2550

Nutrition specialist for World vision Ethiopia

Normal user

14 Jun 2014, 13:34

As to me its better to wait till last minute to provide them take-home RUTFs if they are critically in need of the programmes support and arrive at that specific time. But this doesnt mean that other exit strategies should not be in place, this is just to strech hands for every humanitarian response; I totally Agree!

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