MAMI Care Pathway Package, Version 3 (2021)

The MAMI Care Pathway applies an integrated care pathway approach to the management of at-risk infants under 6 months and their mothers within systems of health. It frames the planning and provision of follow through care of infants who are born vulnerable or become so in early life until they reach 6 months of age, and their mothers. It especially addresses primary and community level care provision.

This approach provides a framework and implementation resources to help put policies into practice and strengthen their delivery, including WHO 2023 guidelines on prevention and management of wasting, Integrated Management of Childhood Illness (IMCI), well-baby care and maternal health and nutrition.

The MAMI Care Pathway Package (v3, 2021) provides a framework and resource materials to help guide practitioners and those who plan services to identify and strengthen pathways of care within existing services and contextualised accordingly.

[Suggested citation: MAMI Global Network, ENN, LSHTM. MAMI Care Pathway Package. v3. 2021. https://www.ennonline.net/mamicarepathway]

Materials to help contextualisation

How to apply the approach will depend on the context, including needs, setting and service realities and resourcing. Local consultation to determine needs, what services are existing, need to be strengthened or added is a critical first step to securing a feasible, sustainable pathway of quality care.  Embedding within existing services is essential and can be helped by mapping ‘who, what and where’:

• MAMI Care Pathway. Who, What, Where?
• MAMI Care Pathway: Overview (blank)
• Documenting Adaptive Learning Toolkit: Templates and Resources to Support the Documentation of Adaptive Learning
• Accelerating Adaptive Learning: Resources, Tools, and Insights from MOMENTUM. USAID MOMENTUM

Examples of contextualisation with a view to future sustainable scale within systems is explored in ENN-led case studies from Pakistan, South Sudan and Yemen.

Materials to inform implementation

Sample forms are provided to help appraise existing materials to determine what may be missing or needs reinforcing or adapting.  In exceptional circumstances, these can be used as a starting template where materials do not exist, such as implementation research or where existing services have been severely disrupted, such as in acute emergency. 

• MAMI Rapid Screening Guide
• In-depth assessment and classification of risk: MAMI Assessment Form (Feeding Assessment & Maternal Mental Health Assessment)
• MAMI Enrolment and Follow Up Form until 6 months of age
• Counselling Cards and Support Action Booklet - Version for printing

Materials for monitoring & evaluation

Indicators to monitor and evaluate care processes and outcomes of infants under 6 months should ideally be embedded within government data systems. Interim standalone or complementary data collection in programmes and research should contribute and not duplicate existing systems.

Guidance developed by Save the Children for use in their programmes is available here: Monitoring and Evaluation Guidance for MAMI Implementation (Save the Children, 2022)

Materials for orientation, training and planning

Training needs will be highly context specific. Wherever possible, training should apply and build on local protocols and resources and use existing capacities. Embedding MAMI Care Pathway components within IMCI training is recommended wherever possible.

• MAMI Care Pathway Package document explains how the tools were developed and by whom and details on how to navigate the forms in practice.
• Health Worker Support Materials User Booklet can help appraise and guide training and the process of implementation in existing services.
• MAMI Care Pathway Training Package for Frontline Workers (Save the Children, 2023: NGO led programming)

Reference materials for technical supervisors/trainers:

• MAMI Mental Health Support summary 
• Identifying and supporting infants under 6 months with feeding difficulties and disabilities: an overview of resources and evidence
• Kangaroo Mother Care: for all small newborns everywhere video and resource list
   

Examples of applying MAMI Care Pathway 

• Pakistan, South Sudan, Yemen MAMI Deep Dive Country Case Studies: Learning by Doing (ENN, 2024)
• MAMI Toolkit - USAID MOMENTUM, Sudan, Niger (English and French). MIHR. Nov.2024.
• Join the MAMI Global Network and MAMI Implementers’ groups (anglophone and francophone) to ‘learn by doing’ together
• MAMI YouTube presentations on evidence and practice
• MAMI RISE, Stronger evidence towards future scale up: randomised cluster trial and process evaluation, Ethiopia (2019-2025)
• Field Exchange Special Section on MAMI (ENN, 2018)
• Videos: MAMI Global Network - Who We Are (Le Réseau Mondial MAMI – Qui Sommes-Nous ?)

[Editable versions of some materials in MS Word and adapted country examples are available on request from mami@ennonline.net]

[Development of the MAMI Care Pathway Package was funded by Irish Aid, the Eleanor Crook Foundation and the Waterloo Foundation.]
[Version 3 replaces Version 1.0 C-MAMI Tool 2015 and the Version 2.0 update in 2018.]