As we reach 15 years since Concern Worldwide’s (Concern) initial pilot evaluations of Community-based Therapeutic Care (CTC) in 2000 in Ethiopia, we reflect on our achievements over this period and where Concern’s Community-based Management of Acute Malnutrition (CMAM) programmes are today. This paper will be of interest to those who would like to know more about Concern’s role in the evolution of managing severe acute malnutrition (SAM) and more about our current CMAM programming.
A child is acutely malnourished when he is too thin for his height (wasted) or has nutritional oedema (swelling of the limbs). Acutely malnourished children are further classified as having SAM or moderate acute malnutrition (MAM) depending on the severity of their wasting. Children under five years of age with SAM are almost 12 times more likely to die than children who have a normal weight for their height. i Globally it is estimated that at least 52 million children under five years of age are acutely malnourished. Of these, approximately 19 million have SAM. ii Despite the fact that CTC was an improved system from the original centre based therapeutic feeding, particularly in terms of achieving increased coverage, the most recent coverage estimates found that of 60 countries who reported SAM data 28 (47 percent) reported treatment coverage of less than 25 percent showing that coverage remains extremely low. It also found that these countries contain almost 85 percent of the estimated global SAM burden. iii Therefore, there is still a long way to go to scale up treatment and prevention efforts. Concern is committed to continue to be involved in this effort.