management of acute malnutrition in niger: a … · dr guero h.doudou maimouna republique of niger...

Dr GUERO H.DOUDOU Maimouna

REPUBLIQUE OF NIGERCMAM/SUN Conference14th-17th November 2011Addis Ababa, Ethiopie

Scaling up community management ofacute malnutrition and scaling up nutrition

MANAGEMENT OF ACUTE MALNUTRITIONIN NIGER:

A COUNTRYWIDE PROGRAMME

Niger, Management of acute malnutrition : a countrywide programme

≤ 10 %

10 % - 15 %

≥ 15 %

Prevalence of SAM : 3,1%Prevalence of MAM : 12,3%

Current coverage CRENI/CRENAS

50 CRENI(coverage 100%)

850 CRENAS(coverage 92%)

1000 CRENAM(coverage 47%)

CRENI = in-patient (SAM)CRENAS = out-patient (SAM)CRENAM = out-patient (MAM)

Niger, Management of acute malnutrition : a countrywide programme

- Establishment of a core group (coordination)

- Quick survey of the nutritional situation and identificationof vulnerable areas- Development of a national protocol for management ofacute malnutrition- Distribution of humanitarian NGOs; supplies, training,M&E

Niger, Management of acute malnutrition : a countrywide programme

-2006 to 2008:

- Continuation of CMAM services- Strengthen nutrition coordination in all regions andyearly nutrition surveys and studies- Transfer of knowledge of NGOs to government services- Establishing primary health care facilities- Introduction of free health care for vulnerable groups(U5 children and pregnant women)

2009 to 2010:

- another food security crisis; upgrade of nutritiondivision to directorate level

- Wider scale-up of CMAM with improved coordinationat all levels

Niger, Management of acute malnutrition : a countrywide programme

-

2011:

• Food security and nutrition symposium established bygovernment (SISAN) developing political and 5 yearstrategic document for nutrition

• Financing through internal and external sources

• budget line dedicated for nutrition within the healthbudget

• Join the SUN and REACH international movements

• Recently, the President launched an initiative tostrengthen food nutritional security in the country (3N)

• Linkages improved between other public healthprogrammes (vaccination, IMCI and HIV/AIDS)

Niger, Management of acute malnutrition : a countrywide programme

Results: Cure rates by region Jan-Oct2011 (of 230,907 SAM admissions)

Default rates by region Jan-Oct 2011

Death rates by region Jan - Oct 2011

1. Increasing political commitment for nutrition

2. Strong leadership from ministry of publichealth for coordination

3. Technical support and assistance frompartners (UN, NGOs, etc)

4. Development of longer-term strategies toaddress malnutrition

• Challenge 1: How to ensure and maintainquality care in all treatment centers(especially recruiting enough trained healthstaff);

• Challenge 2: How to sustain adequate suppliesof expensive therapeutic products (currentlyprovided by partners);

• Challenge 3: how to scale-up MAMprogrammes across the whole country

• CMAM success relies on strong governmentvision and commitment for strategy,coordination and resource mobilisation

• Strong government coordination is vital,especially when many partners are involved

• Standardisation of treatment is key to ensureequity in treatment and comparable data

• Partners prefer to focus on treatment notprevention. There is a need for morepreventative programming

Next steps

• Adoption of national nutrition plan

• Implementation of SUN and REACH

• Expand programmes across the whole country

• Development of national preventativenutrition strategy based on ‘best practices’

• Build community capacity for healthybehaviours

Nutrition is an integrated part ofdevelopment; there is no

development without goodnutrition

Acknowledgements

•Government of Niger

•UNICEF – Professor Eric Ategbo

•ENN – Emily Mates

MERCI Thank you