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MAM versus SAM ratio, indicator of improvement?

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Elisa Dominguez

ACF Medical coordinator

Normal user

28 Jan 2013, 17:53

We have been evaluating MAM and SAM rates in the last national SMART surveys in Burkina in the region were we are working and we observe a progressive increase on MAM ratio versus SAM (MAM prevalence/SAM prevalence). Dos it mean that SAM cases are decreasing compared to MAM cases? could it be this an indicator of improvement of the severity of the situation? or an indicator on the impact of our intervention supporting SAM management? any study available on such issue?

Thanks in advance!

Chantal Autotte Bouchard

AAH

Normal user

28 Jan 2013, 20:27

Hello
Can we fight against malnutrition in the community, using local products without resorting to industrial supplements? If so, can I have an experience from elsewhere for an implementation in a given area according to the local products of the area?

Pascale Delchevalerie

Nutrition Advisor MSF Belgium

Normal user

29 Jan 2013, 09:27

hello,

We observed the same phenomena in Somali region of Ethiopia in 2000: we opened a project for nutritional emergency and IDPs due to drought with very high mortality and SAM. After few months of intervention, the MAM ratio versus SAM increased due to decrease of SAM. this was correlated also with a decrease of mortality. I think different factors explained that we could decrease SAM but not MAM:
1) context of chronic food insecurity
2) lower coverage of MAM cases because active screening done with MUAC, not detecting a large number of MAM in W/H: at the opening of the program we had a very good coverage because the nutrition program was one of the only way to get food ration, so everybody was trying to be admitted in the program, but when food availability improved, spontaneous admissions of MAM decreased.

Hope this help

Mark Myatt

Consultant Epideomiologist

Frequent user

29 Jan 2013, 14:44

Some hand-waving ... You may like to think of this in terms of (1) fat-tails and thin-tails in the distribution of MUAC or WHZ and (2) the distribution of MUAC and WHZ being a "finite mixture" (see this thread. In this "model" we could interpret a reducing SAM:MAM ratio as a change in one of the distributions (e.g. by treatment, reduction of risk, or death).

Any help?

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