CMAM Training to prevent Malnutrition in Peades

CMAM training for preventing malnutrition

1. Presented To: Ma’am Wajeeha Presentation Topic: CMAM

2. FATIMA RAZZAQ 028 EISHAH QUDDUS 005 RAMEEN SAFA 015 RIMSHA MAJEED 030 ANUSHA IQBAL 026 GROUP MEMBERS:

3. Fatima Razzaq 028 PRESENTED BY:

4. CMAM in Pakistan: According to National Nutrition Survey, the rate of wasting was 15.1 (2011) in Pakistan. In Pakistan, there is a burden of acute malnutrition. In government programmes, different CMAM component may vary like OTP may run from: Basic health units (BUHs) or Rural health centres (RHCs) or from health houses by Lady health workers (LHWs)

5. CMAM: The Community-Based Management of Acute Malnutrition (CMAM) approach enables community volunteers to: Identify acute malnutrition & Initiate treatment for children with acute malnutrition before they become seriously ill .

6. Cont.. Caregivers provide treatment for the majority of children with SAM in the home by using: Routine medical care and Ready-to-Use-Therapeutic Foods (RUTF) CMAM programmes are designed: To reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.

7. Implementation of CMAM: Target groups: Acutely malnourished children less than five years. It is also implemented where there are aggravating factor. Aggravating factor include: G eneralized food insecurity, widespread communicable diseases and high crude death rate. 

8. Components of CMAM:

9. EISHAH QUDDUS 005 PRESENTED BY:

10. Community outreach: In order to ensure the effectiveness of CMAM programme, community outreach is crucial. Community should understand the purpose of programme. Community workers need to explore why children become malnourished. Purpose : Promote understanding and ownership of the programme. Aims to improve effectiveness through early detection of cases. Maximizing coverage .

11. Cont.. Strengthen active case finding, referral and follow up. Understand reasons why people do not access services . Basic requirements for CO: WHO conduct CO, include Lady Health workers, Community midwives and other community health workers. WHERE it takes place at community level. CO workers do outreach from health centres, through home visits. WHEN follow up and community meetings with caretakers for children in the programme.

12. Elements of community outreach: Understanding Community: Understand community structure for effective outreach. Useful to have information about key stakeholders. CMAM messaging: Key messages about CMAM can be conveyed by community outreach workers. To anyone presenting at health facility level.

13. Community engagement: CMAM messages, dialogue can be held with community about what programme does. Case finding: Infants, children & PLW with acute malnutrition need to identified asap and referred for treatment. Linking with CMAM: For effective treatment and follow up, there must be good linkage between the health facility and community health workers. Follow up:

14. RAMEEN SAFA 015 PRESENTED BY:

15. Targated supplementary feeding program TSFP Children and pregnant/lactating women with acute malnutrition are provided to:  take-home food rations and routine basic treatment for families of children with moderate malnutrition but no medical complications support for other groups with special nutrient requirements, including pregnant and lactating mothers

16. Guidelines for TSFP The purpose of TSFP To treat moderately acutely malnourished children and acutely malnourished pregnant and lactating women Reduce mortalilty and morbidity among children 6 to 59 months To rehabilitate referrals frim therapeutic feeding programmes Basic requirement for TSFP WHO is qualified to run TSFP WHERE? OTP or at a separate site WHEN? Designated day or every two weeks

17. Procedure for admission STEP 1: Measure MUAC, weight, asses oedema and health conditions STEP 2: Give routine medication and supllementation STEP 3: Give TSFP ration and key messages Fortified blended foods: C orn soy blend and wheat soy blend Fortified with vitamins and minerals Contain about 350-400kcal/100g Oil added to endure adequate energy Oil fortified with vitamin A PREMIX

18. STEP 4: Give key messages STEP 5: TSFP follow up visits

19. PRESENTED BY: RIMSHA MAJEED

20. 3.

21. 6.6: IYCF AND MATERNAL NUTRTION IN OTP INFANT AND YOUNG CHILD FEEDING

22. 6.8: EXIT PROCEDURE: Explain to the caretaker that the child is recovered Where there is a TSFP, children discharged from OTP Where there is no TSFP, refer to other ongoing community health Children who have not recovered (not met the exit criteria) after four months in the programe should be sent to the TSFP and/or other support programe . Note the final outcome o n the OTP card Advise the caretaker to take the child to the nearest OTP or health facility if the child refuses to eat or has any of the following: High fever Frequent watery stools with blood or diarrhea lasting more than 4 days Difficult or fast breathing Vomiting Development of oedema Follow the IYCF discharge actions. Ensure the caretaker understands how to use any medications that have been given / prescribed 6.7: EXIT CRITERIA FROM OTP

23. Anusha Iqbal Manzoor 026 PRESENTED BY:

24. INPATIENT CARE IN A STABILISATION CENTRE SAM children and with medical complication are treated as inpatients in SC until stabilized. Acutely malnourished infants 1-6 months are also treated in SC. It is link with OTP to allow early discharge and continued treatment in the community

25. INPATIENT CARE IN A STABILISATION CENTRE The purpose of the Stabilization Centre: In Children 6-59 months. Infants less than 6 months Screening and referral to the Stabilization Centre: Transfers from OTP Referrals by health care providers at health facility or hospital level Basic requirements for a Stabilization Centre: WHO : Trained staff WHERE: Hospital WHEN: Re-gain appetite

26. Basic Supplies and Equipment: Admission Criteria:

27. STEPS FOR ADMISSION AND TREATMENT STEP 1: Triage urgent case STEP 2: Measure MUAC, weight, asses edema STEP 3: Medical Assessment STEP 4: Admission to SC STEP 5: Asses and treat any complications STEP 6: Give routine medication STEP 7: Start treatment with F75

28. Failure to reposed to treatment : Discharge criteria from SC children 6-59 months

29. THANK YOU