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© Susana Vera
ACUTE MALNUTRITION
A Preventable Pandemic
Measuring for the Weight/Height Index Measuring the middle upper arm circumference (MUAC)
STRUCTURAL FACTORS
POVERTY During the last two decades, extreme TRADE POLICY The major food crises that have
poverty in Sub-Saharan African has nearly recently buffeted Sub-Saharan Africa stem
doubled, from 164 million in 1981 to some from a lack of access to food, not a lack of
313 million as of 2002. Poverty alone does not availability (i.e., the markets are full, but prices
explain the presence of famine, although it does are too high and the poor don’t eat). Prices have
affect the state of food security among the most remained high because much of what is produced
vulnerable of populations. domestically is exported while the economic
powers that control the cereal markets have
GENDER The benefits stemming from the colluded to keep prices high.
education of women constitutes the single
greatest contribution to the reduction of HIV & AIDS HIV and AIDS have become one of
malnutrition from 1970 through 1995, accounting the primary causes—and consequences—of
for 43% of all progress made. Women, after malnutrition. An HIV positive child has a
children, are the most susceptible to the ravages greater chance of contracting malnutrition than
of hunger. his healthier counterparts. Moreover, anti-
retroviral treatments do not perform as well on
CLIMATE CHANGE During the 1990s, it is malnourished children, and life expectancy is
estimated that natural disasters were responsible considerably shorter for patients who lack proper
for $600 million dollars in losses each year, more diets.
than twice the losses reported during the 1980s.
According to the UN’s Food and Agriculture
Organization (FAO), in nearly 40 developing
countries, the losses in agricultural production
attributed to climate change could dramatically
increase the estimated number of people
suffering from hunger in the near future.
1 2 3
TRIGGER FACTORS
ID
M
YRA
VIOLENCE Violence is one of the principal causes
ER P
of acute malnutrition. The disruption of food
production and distribution networks, whether a
G
HUN
deliberate military objective or the consequence
of armed conflict, violence is one of the primary
THE
causes of severe food shortages, and therefore of ACUTE
acute malnutrition. MALNUTRITION
4
ACUTE MALNUTRITION AROUND
THE WORLD
Countries with the highest incidences of acute malnutrition.
Source: The State of the World’s Children 2008, UNICEF
A
• Child has no appetite
• Has major medical
PHASE 1 TRANSITION P
Administration of therapeutic Administration of ther
complications
milk formula F-75 to jumpstart formula F-100 until th
• At least 3 cases of
a child’s metabolism and restore metabolism stabilizes
bilateral edema pitting
hydroelectric equilibrium. foods can be introduc
(Kwashiorkor)
B
• Child exhibits appetite
• No major medical
complications
• Fewer than 3 cases of
bilateral edema pitting
(Kwashiorkor)
The treatment of acute malnutrition consists of 3 Once they have recovered their appetites
components: and received treatment for their medical
complications these children are referred to
COMMUNITY MOBILIZATION: “HOME VISITORS” the outpatient programs (“home treatment”) to
To achieve maximum program coverage, continue their regimen, beginning Phase Two.
resources must be focused on mobilizing a large The average stay in a hospital setting varies
number of community volunteers who work between 10 to 15 days, depending on each child’s
directly with Action Against Hunger’s field teams medical recovery.
of home visitors. These teams are responsible for
identifying early cases of childhood malnutrition THERAPEUTIC OUTPATIENT CARE:
so that timely interventions can keep them from “HOME TREATMENT”
deteriorating further. PHASE TWO
Children who suffer from severe acute malnutrition
THERAPEUTIC INPATIENT CARE: but who are otherwise clinically stable—i.e.,
“HOSPITAL TREATMENT” present no major medical complications, exhibit
PHASE ONE + TRANSITION PHASE fewer than three cases of edema pitting, and who
Children with no appetite and serious medical still possess an appetite—are admitted directly
complications are admitted into specialized into Phase Two and treated in community-based
treatment centers, or hospitals. These children outpatient programs. These children receive medical
represent about 10-20% of severe acute cases. supervision during weekly visits to therapeutic
stabilization centers where medical staff evaluate
Once under hospital supervision, these children their progress and provide them with the weekly
undergo two phases of treatment. Phase One supply of therapeutic RUFs needed to continue their
involves the administration of a specialized milk home treatment—along with doses of antibiotics,
formula, F-75, a therapeutic nutritional product vitamin A, anti-parasite and anti-malaria medicines,
with a low calorie load designed to jumpstart and measles vaccinations. The average treatment
a child’s metabolism and restore hydroelectric period lasts about a month and a half but depends
equilibrium. This phase is followed by a Transition on each child’s progress.
Phase in which another milk formula (F-100)
is administered until the child’s metabolism
stabilizes and solid foods can be introduced.
ACTION AGAINST HUNGER
Action Against Hunger firmly believes it’s possible to How can we expect to build for the future if
put an end to acute malnutrition. Acute malnutrition millions of people around the world begin life
in children under five years of age increases their without hope or the possibility of prospering?
risk of death, inhibits their physiological and
mental development, has life-long implications for
their health, and greatly limits the opportunities
available to future generations. Children with acute
malnutrition today are the poor of tomorrow.
In 2000, 189 countries ratified the United Nations’ ACF’S POLICY RECOMMENDATIONS
eight Millennium Development Goals. Eight years
later, global hunger, acute malnutrition, and
• Treatment strategies for acute malnutrition
child mortality rates remain as some of the more
must receive priority within public policy,
urgent challenges confronting the international
facilitating systematic treatment and access
community.
to RUFs.
The Millennium Development Goals of reducing
• Prevention and risk-reduction programs
global hunger by half and childhood mortality by
must be integrated into treatment programs,
two thirds cannot be realized without prioritizing
guaranteeing that underlying causes are
acute malnutrition.
addressed.
No country can afford to squander their most
• Retool the international humanitarian system to
precious of resources—their human capital.
prioritize acute malnutrition: Food aid pipeline
Nutritional improvements reinforce a population’s
strategies, the UN’s nutritional support, national
productive capabilities, with direct implications for
nutrition protocols, must all emphasize putting
the process of development and poverty rates.
an end to acute malnutrition.