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Community based Management of
ACUTE MALNUTRITION
Objectives
 To understand the aims of Supplementary
Feeding Center
 To learn Protocols of SFP
SFP: Aim
 Reduce mortality and morbidity among children 6 to
59 months.
 Treatment of MAM and prevention of deterioration in
the nutritional status of acutely moderately
malnourished children to become SAM
 Treat and prevent deterioration in the nutritional
status of pregnant and lactating women for a defined
time period.
SFP: Protocols
 Registration
 MUAC / Weight / Edema
 Physical Examination (will be covered in OTP)
 Nutritional Treatment
 Vitamin A & Mebendazole at admission
 Follow-up record
 Fortified Blended Food (FBF) directions & Health
Education
SFP: Criteria for admission
 Children 6-59 months
 MUAC ≥ 11.5 cm and < 125 cm OR
 No bilatteral pitting edema
 Pregnant & lactating Women
 In second and third trimester with MUAC < 21 cm
 Lactating Women MUAC < 21 cm with infants < 6 months
 Others
 Children transferred by the OTP after completing OTP criteria for
rehabilitation.
 Children transferred by SC after stabilization
 Readmission after default
 Readmission after successfully treated
 Infants less than 6 months are not included in SFP.
SFP: Discharge criteria 1
MUAC is more than 12.5 cm for two consecutive
programme distributions (cured)+ minimum 2
months stay
Have been absent for more than two consecutive
distributions (defaulters)
Have to be transferred to OTP with MUAC <115mm
or on developing nutritional oedema;
SFP: Discharge criteria 2
Have to be transferred to a stabilization centre or
hospital due to severe medical complications;
After being discharged from OTP, have received at
least two months follow up in the SFP and have
been more than 12.5 MUAC for two consecutive
programme distributions.
SFP: Follow-up 1
Every registered patient is given schedule of their
next SFP visit.
At each outpatient care follow-on session, the
child receives a comprehensive evaluation that
includes:
anthropometry, medical history, and physical
examination
SFP: Follow-up 2
monitoring the progress of the child’s nutritional
status
verifying and excluding the presence of medical
complications
decision making for referral to inpatient care or
OTP depending on the protocol, for a follow-up
home visit, or for discharge
WFP-UNICEF Joint MOU for SFP
 UNICEF Role. OTP, SC, Screening, Identification, Referral, Follow up,
provide medical treatment to OTP,SC and SFP, reporting etc.
 WFP Role. Provide SFP food for MAM cases. Provide transportation
charges, Orientation of partners on utilization of WFP food.
SFP: Treatment
Nutritional treatment in SFP is given through a
supplementary ration.
This is not intended to meet all the nutritional
requirements but is to supplement the diet taken at
home.
SFP: Blended Food Ration for
Children
Supplementary Plumpy.
Supplementary Plumpy @ 2.76 kg/Child/month (
One sachet of 92gms/day/child)
HEB for siblings ( SFP + OTP) -- avoid food
sharing.
(2.25kg/month)
SFP: Blended Food Ration For
PLW
FBF
Fortified Blended Food @ 7.5kg/PLW/Month
Two weeks= 3.75kg for two week ( 250gms/d/PLW)
Oil @ 2.25kg/PLW/Month. ( One can of 4.5kg/PLW
for two months) ( 75gm/day/PLW)
.
SFP: Routine Medicines
Routine Medicines for SFP
Name of Product When Age Prescription Dose
< 6 months (if not
breastfed)
50 000 IU
6 months to < 1 year 100 000 IU
VITAMIN A
At
admission
> = 1 year 200 000 IU
Single dose on
admission
MEBENDAZOLE
At
admission
< 1 year DO NOT GIVE Nothing
SFP: Routine Medicines
Name of
product
When Age Prescription Dose
MEASLES
VACCINATION
On
admission
Children from 6
months
Standard
Once on
admission
IRON/FOLIC
ACID
At
admission
2 -59 months
Give if signs of
mild/moderate
anaemia
See iron/folic
acid protocol
On admission
Pregnant and
lactating
women
Give iron/folate
to all pregnant
and lactating
women
See iron/folic
acid protocol
Drug When Age/Weight Prescription Dose
VITAMIN A
At
admission
6-12 months
100 000 IU
Single dose on
admission
>= 1 year
200 000 IU
Pregnant
women
DO NOT GIVE
6 weeks
after
delivery
Lactating
women (post
partum)
200 000 IU
MEBENDAZOLE
**
At
admission
< 1 year DO NOT GIVE
None
12-23 months 250 mg
Single dose on
second visit
SFP: Treatment Notes
Ensure the SFP card is completed (the mother / caretaker
takes the card home and brings it back next visit).
Clear advice needs to be given to mothers caretakers on
how to prepare the ration.
Where appropriate a cooking demonstration can be
conducted for new cases.
Ensure the mother/caretaker understand that the ration is
intended for the malnourished individual and is not to be
shared.
Explain how to store the ration safely.
SFP: Follow-up 1
Every registered patient is given schedule of their
next SFP visit.
At each outpatient care follow-on session, the
child receives a comprehensive evaluation that
includes:
anthropometry, medical history, and physical
examination
SFP: Follow-up 2
monitoring the progress of the child’s nutritional
status
verifying and excluding the presence of medical
complications
decision making for referral to inpatient care or
OTP depending on the protocol, for a follow-up
home visit, or for discharge
SFP: Follow-up 2
monitoring the progress of the child’s nutritional
status
verifying and excluding the presence of medical
complications
decision making for referral to inpatient care or
OTP depending on the protocol, for a follow-up
home visit, or for discharge
A Happy Mother and child:
Beneficiary of Community Nutrition Programme
END
CMAM SFP

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ALL SFP Protocols.pptx

  • 1. Community based Management of ACUTE MALNUTRITION
  • 2. Objectives  To understand the aims of Supplementary Feeding Center  To learn Protocols of SFP
  • 3. SFP: Aim  Reduce mortality and morbidity among children 6 to 59 months.  Treatment of MAM and prevention of deterioration in the nutritional status of acutely moderately malnourished children to become SAM  Treat and prevent deterioration in the nutritional status of pregnant and lactating women for a defined time period.
  • 4. SFP: Protocols  Registration  MUAC / Weight / Edema  Physical Examination (will be covered in OTP)  Nutritional Treatment  Vitamin A & Mebendazole at admission  Follow-up record  Fortified Blended Food (FBF) directions & Health Education
  • 5. SFP: Criteria for admission  Children 6-59 months  MUAC ≥ 11.5 cm and < 125 cm OR  No bilatteral pitting edema  Pregnant & lactating Women  In second and third trimester with MUAC < 21 cm  Lactating Women MUAC < 21 cm with infants < 6 months  Others  Children transferred by the OTP after completing OTP criteria for rehabilitation.  Children transferred by SC after stabilization  Readmission after default  Readmission after successfully treated  Infants less than 6 months are not included in SFP.
  • 6. SFP: Discharge criteria 1 MUAC is more than 12.5 cm for two consecutive programme distributions (cured)+ minimum 2 months stay Have been absent for more than two consecutive distributions (defaulters) Have to be transferred to OTP with MUAC <115mm or on developing nutritional oedema;
  • 7. SFP: Discharge criteria 2 Have to be transferred to a stabilization centre or hospital due to severe medical complications; After being discharged from OTP, have received at least two months follow up in the SFP and have been more than 12.5 MUAC for two consecutive programme distributions.
  • 8. SFP: Follow-up 1 Every registered patient is given schedule of their next SFP visit. At each outpatient care follow-on session, the child receives a comprehensive evaluation that includes: anthropometry, medical history, and physical examination
  • 9. SFP: Follow-up 2 monitoring the progress of the child’s nutritional status verifying and excluding the presence of medical complications decision making for referral to inpatient care or OTP depending on the protocol, for a follow-up home visit, or for discharge
  • 10. WFP-UNICEF Joint MOU for SFP  UNICEF Role. OTP, SC, Screening, Identification, Referral, Follow up, provide medical treatment to OTP,SC and SFP, reporting etc.  WFP Role. Provide SFP food for MAM cases. Provide transportation charges, Orientation of partners on utilization of WFP food.
  • 11. SFP: Treatment Nutritional treatment in SFP is given through a supplementary ration. This is not intended to meet all the nutritional requirements but is to supplement the diet taken at home.
  • 12. SFP: Blended Food Ration for Children Supplementary Plumpy. Supplementary Plumpy @ 2.76 kg/Child/month ( One sachet of 92gms/day/child) HEB for siblings ( SFP + OTP) -- avoid food sharing. (2.25kg/month)
  • 13. SFP: Blended Food Ration For PLW FBF Fortified Blended Food @ 7.5kg/PLW/Month Two weeks= 3.75kg for two week ( 250gms/d/PLW) Oil @ 2.25kg/PLW/Month. ( One can of 4.5kg/PLW for two months) ( 75gm/day/PLW) .
  • 14. SFP: Routine Medicines Routine Medicines for SFP Name of Product When Age Prescription Dose < 6 months (if not breastfed) 50 000 IU 6 months to < 1 year 100 000 IU VITAMIN A At admission > = 1 year 200 000 IU Single dose on admission MEBENDAZOLE At admission < 1 year DO NOT GIVE Nothing
  • 15. SFP: Routine Medicines Name of product When Age Prescription Dose MEASLES VACCINATION On admission Children from 6 months Standard Once on admission IRON/FOLIC ACID At admission 2 -59 months Give if signs of mild/moderate anaemia See iron/folic acid protocol On admission Pregnant and lactating women Give iron/folate to all pregnant and lactating women See iron/folic acid protocol
  • 16. Drug When Age/Weight Prescription Dose VITAMIN A At admission 6-12 months 100 000 IU Single dose on admission >= 1 year 200 000 IU Pregnant women DO NOT GIVE 6 weeks after delivery Lactating women (post partum) 200 000 IU MEBENDAZOLE ** At admission < 1 year DO NOT GIVE None 12-23 months 250 mg Single dose on second visit
  • 17. SFP: Treatment Notes Ensure the SFP card is completed (the mother / caretaker takes the card home and brings it back next visit). Clear advice needs to be given to mothers caretakers on how to prepare the ration. Where appropriate a cooking demonstration can be conducted for new cases. Ensure the mother/caretaker understand that the ration is intended for the malnourished individual and is not to be shared. Explain how to store the ration safely.
  • 18. SFP: Follow-up 1 Every registered patient is given schedule of their next SFP visit. At each outpatient care follow-on session, the child receives a comprehensive evaluation that includes: anthropometry, medical history, and physical examination
  • 19. SFP: Follow-up 2 monitoring the progress of the child’s nutritional status verifying and excluding the presence of medical complications decision making for referral to inpatient care or OTP depending on the protocol, for a follow-up home visit, or for discharge
  • 20. SFP: Follow-up 2 monitoring the progress of the child’s nutritional status verifying and excluding the presence of medical complications decision making for referral to inpatient care or OTP depending on the protocol, for a follow-up home visit, or for discharge
  • 21. A Happy Mother and child: Beneficiary of Community Nutrition Programme