IMAM Overview everything you should know about imam

Well written note on imam

1. INTEGRATED MANAGEMENT
OF ACUTE MALNUTRITION
(IMAM)
The Overview

2. Learning Objectives
•Identify the concepts of IMAM
•Identify the components and principles of CMAM
•Overall IMAM organization in The Gambia

3. Integrated Management of Acute
Malnutrition
•Community-based approach to treating acute
malnutrition (SAM)
–Most children with SAM without medical
complications treated as outpatients at accessible,
decentralized sites
–Children with SAM and medical complications
treated as inpatients
–Community outreach for community involvement
and early detection and referral of cases

4. History of SAM Management
•Traditionally, children with SAM are treated in
Nutritional Rehabilitation Centers (NRCs)
•Advantage of a Therapeutic Feeding Centers
(TFC)/NRC?
•Specialized treatment
•Disadvantages
•Overcrowding resulting in
–Cross infections
–Staff workload increases
•Mothers staying long periods – over 28 days
•Late presentation

5. Overcrowded nutrition rehabilitation
center

6. What is IMAM

7. Principles of IMAM
•Maximum coverage and access
•Timeliness
•Appropriate medical and nutrition care
•Care for as long as needed

8. Maximise Impact by focusing on
Public Health

9. Timeliness: Early versus Late
Presentation

10. Timeliness
•Find children before
SAM becomes very
severe and medical
complications arise
•Good community
outreach is essential
•Screening and referral
by community
volunteers

11. Appropriate Treatment

12. Care as Long as is Needed
•Services to address SAM integrated into the routine
health services
•Treatment of SAM is available as long as there is a
need
•Additional support to health services during
emergencies

13. Components of CMAM
•Community Outreach
•Outpatient Care for management of SAM without
medical complications
•Inpatient Care for management of SAM with medical
complications
•Management of Moderate Acute Malnutrition
(MAM)

14. Community Outreach
•VSGs promote IMAM
activities
•Screening/active case
finding and referral
•Follow up of OTP cases,
defaulters
•Health and nutrition
education
•Understanding of
cultural practices,
barriers, and systems

15. Outpatient Care
•Target group: Children with SAM WITH good
appetite and WITHOUT medical complications
•Weekly or daily follow up visits
•Continued rehabilitation with RUTF and routine
medications
•Health and nutrition education

16. Inpatient Care
•SAM with medical complications or no appetite
•Medical treatment according to the national
protocols
•Return to Outpatient Care after medical
complications are resolved

17. Management of MAM
•Target group: Children 6 – 59 months or
adults with MAM
•Activities:
–Routine medication
–Dry supplementary food rations
–Basic preventive health care and immunization
–Health and nutrition education and counselling

18. Overall Organization of IMAM
18

19. •MOHSW
Developing and standardising Protocols & Tools
Training of trainers and pre-service training
Ordering and distributing supplies to regions
Coordinating and supervising the regions
Integrating with other interventions (IMCI, MCH,
HIV, TB, etc)
Monitoring/evaluation with the Health Information
System
•The National Nutrition Agency (NaNA) provides
technical support
19
National Level

20. The RHD:
Organisation of active screening
Implementation & Supervision of OTP/IPF
Monitoring & evaluation
In-service training/on the job training
Smooth delivery of drugs & nutrition products to
health facilities
20
Regional Level

21. Classification of Acute Malnutrion