CMAM project – Community Based Management of Acute Malnutrition – Ethiopia

ALEGRÍA SIN FRONTERAS
FUNDACIÓN PABLO HORSTMANN

You can support us through: http://www.mgda.es/r/1/11934

Overall purpose of the project:
To fight against the famine and its impact on the health of children under 5 years old and pregnant and lactating women (PLW) caused by the drought consequence of El Niño phenomenon.

During the first phase, we will distribute aid food (Famix-Faffa) to reduce the most acute effects of this humanitarian disaster employing the infrastructures of primary health system (the 8 Health Post located in each of the selected kebeles and their workers) and we will develop the programs of management of severe acute malnutrition (Therapeutic feeding Unit- TFU and Out therapeutic Program–OTP) and moderate acute malnutrition (Supplementary Feeding Program – SFP).
On the second phase, the project willtry to prevent the incidence of malnutrition cases among children under 5 years of age and PLW throughwell established and organized community based management of severe acute malnutrition within the existing health service delivery system.

EXECUTIVE SUMMARY

 Despite significant strides to meet Millennium Development Goals (MDG) and nearly doubling its economy over the past two decades, UNDP’s 2015 Human Development Report and World Bank 2015 Poverty Report confirmed that acute poverty increased in Ethiopia. Despite all this achieves, dependency on rain fall for agricultural activities and climate change makes previously none vulnerable areas to be affected, which leaves Ethiopia susceptible to drought and hunger. (https://www.humanitarianresponse.info/operations/ethiopia)

Ethiopia has remained as one of the African countries which are susceptible to shocks – particularly climate change. We could find analogies in the current year with the pasts El Niño’s of 1997-98 and 2002-03. As a matter of fact, the NOAA CPC forecast that the 2015 El Niño “could be among the strongest in the historical record dating back to 1950”. El Niño-caused drought is devastating livelihoods of poor households across the country, being estimated by the EHCT that 15 million people will require food aid in early 2016. (http://www.unocha.org/ethiopia)

Moreover, livestock deaths are increasing -200.000 in 2015, 450.000 expected on 2016 – producing a significant decrease in consumption and its incomes sources and products. Consequently the terms of trade are unfavorable due to the unseasonable selling which is translated in an 80% decrease on the livestock prices. In contrast, according to data published by the Ministry of Agriculture’s Disaster Risk Management, the price of food staples such as lentils is 73% higher than at the same time last year. Based on the past lessons learned on the episodes of El Niño in the years 1997 and 2002, there is a high probability of a nutritional disaster without an immediate response supported by international community. . (https://www.humanitarianresponse.info/operations/ethiopia)

In 2015, UNICEF projected that 302.000 under five children would suffer from severe acute malnutrition in Ethiopia. While in a normal year the bilge harvest in June marks the beginning of a decline in admissions of SAM children under five years into therapeutic feeding program sites, there has already been a 32.5 per cent increase between July and August 2015. This situation in addition to the expected reduced Meher (October-December) harvest is expected to provoke the peak of SAM cases in February/March 2016. In fact, the number of SAM cases expected in 2016 is 350.000, 1.2 million people may require supplementary feeding and 15 million people is expected to be food beneficiaries.

As the 2015 Mid-Year Review of Ethiopia’s Humanitarian Requirements Document (HRD) reflects, between February and May the number of nutrition hotspot priority 1 woredas doubled from 49 to 97 in Ethiopia. Actually, the number of severely malnourished children admitted to TFPs gradually increased from 18.308 in January to 62.045 in May 2015. . (https://www.humanitarianresponse.info/operations/ethiopia)

The overall purpose of this project is, therefore, to reduce morbidity and mortality of children under 5 years in Dugda District by reaching severely malnourished children through outpatient and inpatient treatment programs, SFP distribution to children under 5 and PLW with MAM.

The major activities employed by the project are strengthening existing government structures like purchasing supplies, organizing CMAM refresher training for service providers (health professionals and health extension workers). During project implementation, supplies such as routine medication will be purchased in consultation with District Health Office (DHO) and service providers will be capacitated for quality service in outpatient and inpatient programs according the National Guideline for Management of Severe Acute Malnutrition.  Meki Catholic Clinic, District and Zonal   Health Offices will be the key actors in supervision, monitoring and during implementation and final evaluation process of the project. The project will establish progress monitoring system in terms of financial and physical accomplishment.

The project expected to start implementation in April 2016 and end December 2016. This project will be implemented in 8 rural kebeles of Dugda District with a total population 28,972. The project further expands its contribution to the level of supporting these Kebeles with nutrition gaps through CMAM intervention approaches.

General Objective

Improving health status of children under 5 and pregnant and lactating women in 8 kebeles of Dugda Woreda.

Specific Objective

1. To reduce the effects of malnutrition in under five children in eight (8) kebeles
2. To identify children under 5 years malnourished children in eight (8) kebeles, management and treatment according protocol.
3. To screen the Pregnant and Lactating women in same kebeles and distribute Famix for those who are malnourished.
4. To train HEW and other health professionals on nutritional screening, management and treatment.

PROJECT IMPLEMENTATION STRATEGIES

• Develop community programs
  • Creation of Focus group discussion (FGD)
• Micronutrient malnutrition
  • Distribution of Vitamin A supplement
• Monthly Screening of Malnutrition in 8 selected Kebeles
• Monthly report
• Management and treatment of Severe Acute Malnutrition
• Therapeutic Feeding Unit (TFU)
  • Admission for SAM management according SAM protocol
  • Measuring weight daily
  • Measuring MUAC weekly
  • Other medical complication management
  • Nutritional counseling
  • Providing F75, F100, RUTF

• Out Therapeutic Program (TFP)
  • Feeding uncomplicated SAM according to the protocol.
  • Health information on Nutrition
  • Measuring weight weekly
  • Measuring MUAC weekly
  • Nutritional counseling
  • Providing RUTF
• Management and treatment of Moderate Acute Malnutrition
  • Faffa/Famix
  • Nutritional counseling
• Traning of HEW
• Training on malnutrition screening and management and treatment