1. www.cmamforum.org cmamforum@gmail.com
Collaborating to improve the management of
acute malnutrition worldwide
COREGroup, Silver Spring, May 6, 2014
Information-sharing to improve learning
about community-based management
of acute malnutrition and its impact

2. www.cmamforum.org cmamforum@gmail.com 2
Supplementary
feeding for the
mgmt of MAM/
malnutrition
Inpatient
mgmt of
SAM
Management of acute malnutrition
before 2000
CURATIVE AND
PREVENTIVE HEALTH
PREVENTIVE
NUTRITION
CURATIVE NUTRITION

3. www.cmamforum.org cmamforum@gmail.com 3
Community outreach:
Early case detection and community engagement
Outpatient
mgmt of MAM
Inpatient
mgmt of
SAM
Outpatient
mgmt of
SAM
RUTF
Management of acute malnutrition
from 2000 on
CURATIVE AND
PREVENTIVE HEALTH
PREVENTIVE
NUTRITION
CURATIVE NUTRITION

4. www.cmamforum.org cmamforum@gmail.com 4
IMCI
Community Outreach:
Early case detection and community
engagement
Outpatient
mgmt of MAM
Inpatient
mgmt of
SAM
Outpatient
mgmt of
SAM
CURATIVE AND
PREVENTIVE
HEALTH AND
NUTRITION
National
production
of RUTF +
CMAM approach
Food security
Social safety nets
WASH
Education
Gender
IYCF - ENA

5. 5
El Fasher
Um Keddada
Mellit
Kutum
Taweisha
El Laeit
Malha
Tawila & Dar el Saalam
Karnoi &
Um Barow
Koma
KormaSerif
Kebkabiya
Fata Barno
Tina
N. Darfur 2001
Hospital with inpatient care
El Sayah
Outpatient care site
100 kms
Inpatient care site

6. www.cmamforum.org cmamforum@gmail.com
Global burden of acute malnutrition
Source: ACF 2014

7. www.cmamforum.org cmamforum@gmail.com
CMAM at scale since 2007
60 countries with CMAM (2012)

8. Coverage of management of SAM
0
5000000
10000000
15000000
20000000
25000000
2009 2011
1,961,72
1,035,
?
2012 # Countries Admissions Expected Coverage
East Asia Pacific 10 31,813 2,231,020 1%
East & South Africa 18 890,414 2,987,674 30%
America & Caribbean 3 28,882 255,636 11%
South Asia 7 258,366 21,999,552 1%
West & Central Africa 19 1,235,302 5,353,337 23%
63 2,662,712 34,692,340 8%
2.6 million children with SAM
admitted for treatment out of an
estimated 34.6 million (about 8%)
Source: UNICEF 2013

9. Integration of management of SAM
CMAM in 2012 (N: 62) YES PARTIAL NO N/A
Management of SAM in national MCHN policy 50 9 3 0
Funds for SAM in annual health sector plan 24 0 35 3
SAM included in costed nutrition plan 39 0 23 0
RUTF on essential supplies list 21 0 41 0
Minimum one acute malnutrition indicator in HNIS 41 0 21 0
Management of SAM included in basic package of
health services
19 31 12 0
Management of SAM as part of M&E and supervision 19 0 43 0
SAM screening in basic package of health services 24 29 9 0
Management of SAM in curricula for clinical health
professions
24 0 38 0
Management of SAM in curriculum for health workers 27 21 14 0
Source: UNICEF 2013

10. www.cmamforum.org cmamforum@gmail.com
Information access issues:
 Inconsistent and ad hoc information sharing and learning
 No one repository for resources
Expressed needs:
 Sharing promising practices and evidence
 Learning from new contexts and innovative strategies that
address challenges
 Improving access to up-to-date, practical, accessible information
 Identifying knowledge gaps
 Avoiding duplication
Challenges for integration and scale up

11. www.cmamforum.org cmamforum@gmail.com
CMAM Forum
Multi-stakeholder initiative to improve health outcomes
through:
 Improved information-sharing to support quality
improvement, integration and scale-up of
management of acute malnutrition interventions
 Easy access to technical guidance, evidence and
learning from nutrition and health actors
Relevant to WHA 2012 Resolution, Target 6: By 2025,
reduce and maintain childhood wasting to less than 5%

12. www.cmamforum.org cmamforum@gmail.com
Steering Committee
Represents different sectors:
 Government: MOH Bolivia, Kenya, Malawi, Niger (Asia pending)
 UN agencies: FAO, GNC, UNICEF, UNSCN, WFP, WHO
 NGOs: ACF, Concern Worldwide, Save the Children
 Technical entities: ENN, FANTA, icddr,b, IMTF, Valid
International
 Academic and professional associations (under discussion)

13. www.cmamforum.org cmamforum@gmail.com
1. Facilitate sharing of information and experience and
capitalise on lessons learned
Open access interactive website (library, country-specific
resources, technical summaries and updates, training and
audio-visual materials, advocacy resources, ongoing research
summary, website links)
2. Develop technical materials to meet identified
information gaps
Technical summaries (technical briefs, FAQs, mapping, updates)
CMAM Forum objectives

14. www.cmamforum.org cmamforum@gmail.com
3. Assess effectiveness via case studies in 4 countries
How CMAM Forum is used and how it can be improved to
better strengthen quality and scale-up
4. Promote/support a harmonised advocacy strategy:
Positioning AM as a major health and nutrition
priority, ensuring issues are raised, articulated, shared
For example the “Generation Nutrition” ACF Campaign
CMAM Forum objectives (continued)

17. www.cmamforum.org cmamforum@gmail.com
Assessing the effectiveness: M&E
• Information products and services
• Audience: members or users
• Reach: breadth and saturation of dissemination
• Usefulness: user satisfaction and quality
• Use: What is done with knowledge gained

18. Adapted from: Sullivan T et al. 2007. Guide to Monitoring and Evaluating Health Information Products
and Services. Washington, DC: USAID.
M&E conceptual framework

19. M&E methods
Routine monitoring (at global and country level)
 Website statistics on website usage
In-depth studies (at global and country level):
 Global member and user e-surveys
 Country case studies (India, Kenya, Niger,
Yemen): member e-survey, KII, FGD
 Mid-term review
 Evaluation

20. www.cmamforum.org cmamforum@gmail.com
Routine monitoring: website usage
• Over 1,400 members from 88 countries (100-150 new
members per month)
• Two-thirds of members are from low-income countries
• Over 10,000 website visits per months
• 20% of website visits from French speaking countries
• 8% of resources in French, 1% in Spanish, and < 1% in
Arabic

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Trends (July 2012–March 2014)

22. www.cmamforum.org cmamforum@gmail.com
Membership profile
Education background: Nutrition-dietetics 52%, medicine 16%, nursing
6%, social-community development 4%, other 13%, unknown 8%

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• Ways for expanding the audience
• Improving national information sharing
• Guidance to key resources
• Topics for technical summaries
• e-Learning courses, podcasts by experts
• Online social networking services
• “Share” link
• Arabic and French resources
• Culturally adapted audio-visual resources
Suggestions for improving (CCSs)

24. www.cmamforum.org cmamforum@gmail.com
CMAM Forum
First phase:
Start-up (September 2011–December 2012)
Second phase:
Consolidation and expansion (January 2013–
December 2014)

25. www.cmamforum.org cmamforum@gmail.com
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cmamforum@gmail.com
Collaborating to improve the management of acute malnutrition worldwide