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

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Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community management of acute malnutrition and scaling up nutrition MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A COUNTRYWIDE PROGRAMME

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Page 1: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

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

Page 2: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

Niger, Management of acute malnutrition : a countrywide programme

≤ 10 %

10 % - 15 %

≥ 15 %

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

Page 3: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

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

Page 4: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

- 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

Page 5: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

-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

Page 6: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

-

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

Page 7: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

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

Page 8: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

Default rates by region Jan-Oct 2011

Page 9: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

Death rates by region Jan - Oct 2011

Page 10: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

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

Page 11: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

• 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

Page 12: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

• 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

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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

Page 14: MANAGEMENT OF ACUTE MALNUTRITION IN NIGER: A … · Dr GUERO H.DOUDOU Maimouna REPUBLIQUE OF NIGER CMAM/SUN Conference 14th-17th November 2011 Addis Ababa, Ethiopie Scaling up community

Nutrition is an integrated part ofdevelopment; there is no

development without goodnutrition

Acknowledgements

•Government of Niger

•UNICEF – Professor Eric Ategbo

•ENN – Emily Mates

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MERCI Thank you