These simple tools are transforming how children are treated for acute malnutrition. Designed for people with low literacy, these tools have the potential to help community health workers treat children with severe acute malnutrition close to home, in areas around the world where the nearest health facility is hours away.
Malnutrition is the single biggest threat to public health according to the World Health Organization. Globally, it contributes to 45% of deaths of children under 5. Treatment for the most severe cases was, until recently, only available at a hospital as around-the-clock care—which is virtually impossible in many low-income countries. With the development of ready-to-use therapeutic foods, this treatment became available in outpatient programs at lower-level facilities, requiring weekly visits for up to 2-4 months.
While this outpatient treatment model has been scaled up to over 60 countries with a high burden of malnutrition, it hasn’t reached every community where it’s needed. Tapping into local networks of community health workers could potentially increase access to care. But the complex treatment protocol and text-based tools aren’t well-suited for those with low reading skills. That’s why the International Rescue Committee, a global humanitarian aid and relief organization, with financial support from the Eleanor Crook Foundation, designed this simplified, visual-aid-based protocol. Over the course of 6 days, community health workers are taught how to diagnose severe malnutrition, measure out daily and weekly doses of therapeutic food, register patients, and give simple treatment advice to caregivers.
And a recent study shows that the protocol works.
Researchers followed 40 trained, low-literate community health workers in South Sudan, tracking their performance using a checklist of steps for treating children with severe malnutrition. Overall, those health workers scored an average of nearly 90% on more than 140 checklists.
Such high performance is tremendously promising, as it could effectively shrink the distance caregivers and patients must travel to access much-needed care.
More work is still needed to clarify whether training and treatment delivery can be scaled up to cover much larger and contextually different areas. But this starting point is encouraging. With continued effort, this local approach to acute malnutrition treatment could prove a powerful antidote to one of the world’s largest threats to public health.