A mapping exercise and online survey to investigate continuity of care in acute malnutrition treatment in East Africa

Between January and June 2019, Emergency Nutrition Network (ENN) undertook a mapping exercise and a review of current practice to gain an insight into the extent to which UN-supported treatment of children with severe acute malnutrition (SAM) is aligned with treatment of children with moderate acute malnutrition (MAM) in East and West Africa (‘continuum of care for acute malnutrition treatment’). In this review, continuum of care for acute malnutrition treatment considers that a child receives appropriate, timely care to recovery, whether they are moderately or severely acutely malnourished including complicated cases. This constitutes part of a broader continuum of care that encompasses prevention.

This exercise was part of a wider ENN initiative to collate and appraise experience and evidence around the delivery of UNsupported/ led acute malnutrition treatment programmes in relation to continuum of care for acute malnutrition treatment1. In the context of existing policy guidance and institutional arrangements2 and using secondary UN-sourced data, SAM treatment was examined as those services supported by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), and MAM treatment was examined in the form of targeted supplementary feeding programmes (TSFPs) delivered/supported by the World Food Programme (WFP).

This report presents the findings of the East Africa review from both the online survey (regional/country results) and the collection of data on admissions (2017-2018) for SAM and MAM treatment for those countries where both sets of data were available for comparison. Specifically, data is presented on: geographical and treatment coverage of SAM and MAM services; SAM and MAM admissions data by country; qualitative data from the online survey by country; and an insight into regional practice in the admission and referral of children with SAM and MAM. The report also presents and discusses data pertaining to admissions and referrals between SAM and MAM services, availability and coverage of services to treat acute malnutrition, and the continuum of care between the two. Recommendations are framed within existing operational arrangements with regard to improving the availability of data (including admissions, referrals, coverage); targeting criteria; coordination; mapping of SAM and MAM services and the linkages between them; addressing supply pipeline issues; harmonising service provision; building capacity for referral; and review/adaptation of protocols.