The document discusses an online malnutrition course developed by the University of Southampton and International Malnutrition Task Force. It provides the following information: 1) The course trains health workers worldwide in managing severe and acute malnutrition in infants and children. An evaluation study is underway to assess the course's effectiveness. 2) The evaluation involves surveys of past students and will also take place in Ethiopia, Ghana, and Guatemala to study the course's real-world impact. 3) The course aims to significantly improve treatment of childhood malnutrition globally by providing free online training to health professionals.

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Malnutrition eLearning Newsletter
April 2015
Welcome to the 7th newsletter
The Malnutrition eLearning Course,
developed by the University of
Southampton and the International
Malnutrition Task Force (IMTF), is a freely
available course to train health workers
across the world in the management of
Severe and Acute Malnutrition (SAM) in
infants and children.
The course is available at:
www.som.soton.ac.uk/learn/test/nutrition/
Evaluation Study News:-
The effectiveness of the Malnutrition Course
is currently being evaluated by a 2-year
research project. The first phase of the
study has begun with a survey for students
and health workers who have already done
the course. It is important to discover if the
course is making a significant impact,
providing information and changing practice
in the treatment and management of
childhood malnutrition.
The second phase of the evaluation will take
place in Ethiopia, Ghana and Guatemala. Dr.
Demeke Mekonnen Mengistie the Principal
Investigator for the Ethiopia Team recently
visited the project team based at University
of Southampton to help plan the study. It
was a great opportunity to meet Demeke
and find out more about the progress of the
study in Ethiopia.
If you have used the malnutrition course,
(even if you did not finish) please help us
by fillingin the questionnaire. Click here
for the link to the survey
For more information regarding the study,
please visit our website:
www.som.soton.ac.uk/learn/test/nutrition/m
ele/about/
Thank you if you have already completed
the questionnaire.
About the Course
The aim of the Malnutrition Course is to
provide training to Health Care Workers
across the world in the management of
Severe Acute Malnutrition. We believe that
with the correct training we can make a
significant difference to the plight of
children internationally. The course is
used in the teaching of undergraduate and
MSc students, and in-service health
professionals. The benefit of this course is
the fact that it can be completed on-line
and in your own time. Content is based on
the World Health Organisation guidelines
and assessment and feedback are provided
throughout the course. A certificate is
provided upon completion.
A summary from Professor Ann Hill
Ann Hill is Professor of Community
Nutrition in the Public Health Nutrition
Unit at the London School, of Hygiene and
Tropical Medicine. She has been working
with Malnutrition since 1964 and assisted
in the writing and development of this
Course. Having been promoting the need
for effective training for many years. Read
the great account of what challenges she
has faced over the years and how she sees
the future (see page 3).

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COMMUNITY:-
Certificate Giving Ceremony
These photos of students receiving their
Malnutrition eLearning Certificates were
sent to us by Xolile Mkhize, Senior Lecturer
at Mangosuthu University Of Technology,
Durban, South Africa. These students and
community workers are part of food
security project in South Africa.
Worth a look:-
Double Burden Map
The Global Alliance for Improved Nutrition
(GAIN) has just launched the Double Burden
Map which is an online tool showing the
true scale of malnutrition globally.
To view visit:- http://bit.ly/1Ds99Gy
It provides data from over 30 countries both
developing and developed countries,
whether that is under-nutrition or obesity.
The first ever Global Nutrition Report was
published earlier this year. This is a review
of the progress being made. To download
the report, click here.
Scaling up Nutrition is a movement based
on the principle all people have a right to
food and good nutrition. They work to bring
together people in a collective effort to
improve nutrition. To find out more please
visit their website: -
http://scalingupnutrition.org and see their
efforts towards Scaling Up Nutrition.
The CMAM forum have produced this
detailed key resources on the management
of acute malnutrition, a valuable set of
documents for specialists:-
http://www.cmamforum.org/Pool/Resourc
es/Key-Resources-for-mgmt-of-acute-
malnutrition-CMAM-Forum-Dec-2014.pdf
Unicef in Bangladesh have been using
the Malnutrition eLearning Course to
train their Nutrition Consultants.
Feedback so far has been positive with
one participant telling us they have
incorporated what they learnt on the
course in to their daily work. We hope to
bring you more news on this in our next
newsletter.
Join us on Facebook & LinkedIn
The Facebook page “Malnutrition eLearning
Course” has over 1350 followers. Please
“like” the page so your friends will get the
details. In addition, the better known the
page is, the more people will find it.
www.facebook.com/MalnutritionELearningCo
urse
LinkedIn: uk.linkedin.com/in/trevorpickup/
We would like to hear your experiences of
using the Malnutrition eLearning Course. If
you would like to share your news with us,
please contact: - Sally Hickman at
S.A.Hickman@soton.ac.uk. We would love
to hear from you!

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Spreadingtheword:somepersonal
reflections
By Ann Ashworth
International Malnutrition Task Force
The malnutrition eLearning course is the
result of a very long journey. My reflections
relate to some of this journey.
In 1964, I joined a Unit in Jamaica renowned
for its pioneering research on the treatment
of severe malnutrition. When it was first
established, about 25% of children admitted
to the Unit died but the research helped
reduce this to <5%. In 1970, whilst collecting
data about the nutrition situation in Jamaica, I
discovered that none of the island’s district
hospitals had any knowledge about the
correct treatment of severe malnutrition,
although there were many cases. In one
hospital, 50% of cases died. So despite the
Unit’s respected position internationally, and
publications in prestigious journals, the local
impact was zero. So we wrote a treatment
manual and held training sessions and
eventually all hospitals in Jamaica followed
the Unit’s approach. Later the treatment
guidelines were adopted by all countries of
the Commonwealth Caribbean and became
part of the medical curriculum; they also
formed the basis for the 1981 WHO treatment
guidelines.
Rather naively, we expected that treatment
would improve worldwide following
publication of authoritative guidelines by
WHO, but this was not the case. When I
moved to the London School of Hygiene &
Tropical Medicine it became clear that high
mortality among severely malnourished
children still existed in most hospitals of the
world, so in May 1993 a colleague and I
organised a small workshop to review the
situation and make a plan. The participants
(representatives from WHO, UNICEF, Save the
Children, and academics) agreed that I)
mismanagement persisted worldwide, ii)
there was little awareness of the WHO
guidelines, iii) action was needed. Actions
that were emphasised were: -
• presenting treatment in a practical,
user-friendly and memorable form
(such as ‘10 steps’)
• making this accessible through
• multiple and wide distribution
• documenting the evidence for
mismanagement and high mortality
rates (as this wouldbe needed to justify
the need for action)
• videos for advocacy and training, and
support materials.
Following the workshop, we developed ‘10
steps’. Treatment was summarised in 3 pages
and disseminated by Child Health Dialogue
with a circulation of over a million, with
French, Spanish and Chinese translations.
PAHO published the ‘10-steps’ as a leaflet in
Portuguese. We surveyed health workers’
knowledge and practice, and reviewed the
literature, and these provided important
evidence of mismanagement and high
mortality.
WHO produced a second manual in 1999 and a
6-day training course. Although excellent, and
always evaluated highly by trainees, this
course can take only 25 people and is
expensive to run. Only one or two people per
institution can be released for a course like this
and, to have an impact on treatment practices,
the trainees must re-skill their colleagues when
they return back to base. Training the entire
team can be difficult unless everyone is fully
committed.
So the eLearning course is the new engine on
the journey, allowing many more trainees to be
reached than previously. Large numbers of
health practitioners can study on their own or
in groups, and medical, nursing, health science
and nutrition students can equip themselves
with the knowledge needed to treat severely
malnourished children successfully. University
and college tutors find the course helpful in
preparing lectures.
Putting knowledge into practice can be a
challenge but is the vital reward. My hope is
that you will be one of the champions who will
motivate and help others achieve best practice
in the care of severely malnourished children.
It can be life-changing for you, and life-giving to
the children. I wish you success. If enough
people take the course and apply the
knowledge they acquire, then the journey’s
destination (low child mortality and full
recovery) willbe reached.