Community-based management of acute malnutrition in Bangladesh: feasibility and constraints
This article was published in the Food and Nutrition Bulletin [© 2014 United Nations University Press] and The Journal's website is at: https://www.ncbi.nlm.nih.gov/pubmed/25076775
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© 2014 United Nations University Press
2017
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10361-7630 |
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10361-76302017-01-22T10:56:17Z Community-based management of acute malnutrition in Bangladesh: feasibility and constraints Choudhury, Nuzhat Ahmed, Tahmeed Hossain, Md Iqbal Mandal, Barendra Nath Mothabbir, Golam Rahman, Mustafizur Islam, M Munirul Husain, Mohammad Mushtuq Nargis, Makhduma Rahman, Ekhlasur James P Grant School of Public Health, BRAC University Acute malnutrition Bangladesh CMAM Health system This article was published in the Food and Nutrition Bulletin [© 2014 United Nations University Press] and The Journal's website is at: https://www.ncbi.nlm.nih.gov/pubmed/25076775 Background. To achieve the United Nations Millennium Development Goals, particularly reduction in child mortality (Millennium Development Goal 4), effective interventions to address severe and moderate acute malnutrition (SAM and MAM) among children under 5 years of age must be implemented and brought to scale alongside preventive measures. Bangladesh has an estimated 600,000 children with SAM, for a prevalence of 4%, while 1.8 million children suffer from MAM. Objective. To assess the feasibility and constraints of community-based management of acute malnutrition (CMAM), a relatively new approach, in managing SAM and MAM among children in Bangladesh. Methods. The methodology involved desk reviews of documents by searching through PubMed and other databases for published literature on CMAM in Bangladesh. We also did a hand search of policy and program documents, including the draft National Nutrition Policy 2013; the Health, Nutrition, Population Sector Development Program document of the Ministry of Health and Family Welfare, Government of Bangladesh; the Sixth Five Year Plan; and the Operational Plans of the National Nutrition Services of Bangladesh. Results. The conventional approach in Bangladesh has been to treat children suffering from SAM and associated complications in hospital settings. There is no program to take care of children with MAM. There is a dearth of local evidence to operationalize and implement CMAM in the context of Bangladesh. This paper summarizes the scientific literature and rationale for the implementation of CMAM in Bangladesh. It also provides recommendations to improve health strategies related to CMAM, discusses diets being developed that may result in better implementation of CMAM, and offers recommendations for areas of additional necessary research. Conclusions. A recommended approach for Bangladesh on the management of acute malnutrition would be to integrate CMAM into the rollout of the National Nutrition Services so that screening, identification, referral, and treatment of acutely malnourished children could be effectively managed within the community-based health service delivery system. Given that the vast majority of children are suffering from MAM and could be treated with locally developed food supplements, a significant emphasis of the CMAM approach in Bangladesh should be to screen and treat MAM. Over time, this would also result in fewer SAM cases. However, even with this approach, there would still be a small number of children who have SAM and who ideally should be treated with specialized therapeutic foods. While the Government of Bangladesh is awaiting full-scale production of a local ready-to-use therapeutic food (RUTF), an interim strategy is needed to effectively treat these severely wasted children on an outpatient basis. Published 2017-01-22T07:30:39Z 2017-01-22T07:30:39Z 2014 Article Choudhury, N., Ahmed, T., Hossain, M. I., Mandal, B. N., Mothabbir, G., Rahman, M., . . . Rahman, E. (2014). Community-based management of acute malnutrition in bangladesh: Feasibility and constraints. Food and Nutrition Bulletin, 35(2), 277-285 03795721 http://hdl.handle.net/10361/7630 en https://www.ncbi.nlm.nih.gov/pubmed/25076775 © 2014 United Nations University Press |
| institution |
Brac University |
| collection |
Institutional Repository |
| language |
English |
| topic |
Acute malnutrition Bangladesh CMAM Health system |
| spellingShingle |
Acute malnutrition Bangladesh CMAM Health system Choudhury, Nuzhat Ahmed, Tahmeed Hossain, Md Iqbal Mandal, Barendra Nath Mothabbir, Golam Rahman, Mustafizur Islam, M Munirul Husain, Mohammad Mushtuq Nargis, Makhduma Rahman, Ekhlasur Community-based management of acute malnutrition in Bangladesh: feasibility and constraints |
| description |
This article was published in the Food and Nutrition Bulletin [© 2014 United Nations University Press] and The Journal's website is at: https://www.ncbi.nlm.nih.gov/pubmed/25076775 |
| author2 |
James P Grant School of Public Health, BRAC University |
| author_facet |
James P Grant School of Public Health, BRAC University Choudhury, Nuzhat Ahmed, Tahmeed Hossain, Md Iqbal Mandal, Barendra Nath Mothabbir, Golam Rahman, Mustafizur Islam, M Munirul Husain, Mohammad Mushtuq Nargis, Makhduma Rahman, Ekhlasur |
| format |
Article |
| author |
Choudhury, Nuzhat Ahmed, Tahmeed Hossain, Md Iqbal Mandal, Barendra Nath Mothabbir, Golam Rahman, Mustafizur Islam, M Munirul Husain, Mohammad Mushtuq Nargis, Makhduma Rahman, Ekhlasur |
| author_sort |
Choudhury, Nuzhat |
| title |
Community-based management of acute malnutrition in Bangladesh: feasibility and constraints |
| title_short |
Community-based management of acute malnutrition in Bangladesh: feasibility and constraints |
| title_full |
Community-based management of acute malnutrition in Bangladesh: feasibility and constraints |
| title_fullStr |
Community-based management of acute malnutrition in Bangladesh: feasibility and constraints |
| title_full_unstemmed |
Community-based management of acute malnutrition in Bangladesh: feasibility and constraints |
| title_sort |
community-based management of acute malnutrition in bangladesh: feasibility and constraints |
| publisher |
© 2014 United Nations University Press |
| publishDate |
2017 |
| url |
http://hdl.handle.net/10361/7630 |
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