S4 Moderate Malnutrition Visuals

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Structure of chapter
Food Security, Nutrition and Food Aid
Nutrition Assessment Analysis
Food Security Assessment Analysis
Food Security
Nutrition
Food Aid
Standard 1 General Food Security
Food aid planning
Food aid management
General Nutritional Support
Correction of Malnutrition
Standard 2 Primary Production
Standard 1 Food handling
Standard 1 Moderate malnutrition
Standard 1 Ration planning
Standard 1 All Groups
Standard 3 Income Employment
Standard 2 At-risk groups
Standard 2 Severe malnutrition
Standard 2 Appropriateness acceptability
Standard 2 Supply chain management
Standard 4 Access to markets
Standard 3 Micronutrient malnutrition
Standard 3 Distribution
Standard 3 Food quality safety
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Correction of Malnutrition Standard 1Moderate
Malnutrition

• Moderate Malnutrition is addressed

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Objectives of Session 4 Moderate Malnutrition

• To review the types of programmes to address
  moderate malnutrition
• To determine the recipients of SFPs
• To outline factors which influence the coverage
  of SFPs
• To determine the exit criteria for SFPs
• To consider alternative ways to address MM

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Ways to address moderate malnutrition
Source Action Against Hunger
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Supplementary Feeding
Source Action contre la Faim
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Types of supplementary feeding programmes
KI 4 5 ? targeted supplementary feeding
GN 6 ? On-site feeding only when fuel,
water, cooking utensils in short supply (eg
displaced / moving)

• KI 7
• ? dry take-home ration unless clear rationale for
  on-site feeding

Preamble? blanket supplementary feeding
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Pros and Cons of On-site and Dry ration SFP

• On-site SFP
• Pros
• see child eating ration
• allows time for education
• security?
• if no resources at home to cook
• Cons
• increased risk of cross-infection
• cost
• time of carer

• Dry-ration SFP
• Pros
• Less risk of cross-infection
• Less time to establish
• Less time for carers
• Lower costs
• Cons
• Dont see child eat ration
• Less time for education

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Determining the recipients of a SFP

• KI 5
• admission of individuals is
• based on..
• anthropometric criteria

• GN 4
• Other individuals
• PLWH/A, TB,
• disabled

Appendix 5 ? - 3 to lt -2 Z-scores
Weight/Height 70 to lt 80 median Weight/Height
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Factors which influence Coverage

• KI 2
• gt 50 in rural areas
• gt 70 in urban areas
• gt 90 in camp situation

• GN 2
• Acceptability of programme
• Location of distribution points
• Security for staff recipients
• Waiting times,
• Service quality
• extent of home visiting

• KI 3
• gt 90 of target pop is within lt 1 days return
  walk for dry ration
• No more than 1 hours walk for on-site feeding

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Exit Criteria in the SFP

• GN 3
• Proportion of exits defaulted
• No defaulters in prog x 100
• No of exits

• KI 4
• Died lt 3
• Recovered gt 75
• Defaulted lt 15

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Calculation of recovered, defaulters and deaths

• recovered No. recovered x 100
• in May Total exits
• 142 x 100
• 175
• 81

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Important points about exit indicators

• Proportions based on exits are not equivalent to
  population rates.
• Key indicators based on exit criteria are
  interrelated and should always be interpreted in
  relation to one another.
• Proportion recovered is the most important exit
  indicator because it reflects the objective of
  selective programmes.
• Defaulter rate will affect recovery rates.

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What other key aspects of SFPs exist?

• Links to existing health structures (KI 6)
• Health inputs included (de-worming, vitamin A
  supplementation, immunisations) (GN 5)
• The quality of supplementary food should be given
  special consideration in high HIV/AIDS prevalent
  areas (GN5)

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Objectives of Session 4 Moderate Malnutrition

• To review the types of programmes to address
  moderate malnutrition
• To determine the recipients of SFPs
• To outline factors which influence the coverage
  of SFPs
• To determine the exit criteria for SFPs
• To consider alternative ways to address MM