Severe acute malnutrition (SAM) affects approximately 13 million children under the age of 5 and is associated with 1–2 million preventable child deaths each year. In most developing countries, case fatality rates (CFRs) in hospitals treating SAM remain at 20–30% and few of those requiring care actually access treatment. Recently, community-based therapeutic care (CTC) programmes treating most cases of SAM solely as outpatients have dramatically reduced CFRs and increased the numbers receiving care. CTC uses ready-to-use therapeutic foods and aims to increase access to services, promoting early presentation and compliance, thereby increasing coverage and recovery rates. Initial data indicate that this combination of centre-based and community-based care is cost effective and should be integrated into mainstream child survival programmes.
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- CFR, case fatality rate
- CTC, community-based therapeutic care
- IMCI, Integrated Management of Childhood Illness strategy
- MoH, Ministry of Health
- MUAC, middle upper arm circumference
- NGO, non-governmental organisation
- NRU, nutrition rehabilitation unit
- OTP, outpatient treatment programme
- RUTF, ready-to-use therapeutic food
- SAM, severe acute malnutrition
- SC, stabilisation centre
- SFP, supplementary feeding programme
- WFH, weight-for-height
Funding: This work was supported by funding from Concern Worldwide. Concern Worldwide has been engaged in the research and development of community-based therapeutic care but has had no influence over the text of this review.
Competing interests: The author works for Valid International Ltd, an organisation that has been engaged in the research and development of community-based therapeutic care. He is also an unpaid director of Valid Nutrition, a not-for-profit company established to research and manufacture ready-to-use therapeutic food in developing countries.
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