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Community Based Management of Severe Acute Malnutrition: The MSF Experience from an Urban Slum Setting in Bangladesh

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Food and nutrition Sciences 2020年第6期11卷 578-589页

作者： Engy Ali Pascale Delchevalerie Zubair Shams Petra Alders Rony Zachariah Luxembourg Operational Research Unit (LuxOR) Medical Department Médecins Sans Frontières—Operational Centre Brussesl Luxembourg Luxembourg Medical Department Médecins Sans Frontières—Operational Centre Brussels Brussels Belgium Bangladesh Mission Médecins Sans Frontières—Operational Centre Brussels Dhaka Bangladesh

Background: Until recently, the experience on implementing community based management of acute malnutrition (CMAM) among children has been largely based in African settings. While the government in Bangladesh is yet to scale up CMAM approach, there is still paucity of knowledge on the experience of CMAM within the complex milieu of an urban slum context. In Kamrangirchar slum, Dhaka, Bangladesh, this paper describes a CMAM programme performance and outcomes run by Médecins Sans Frontières (MSF)/Doctors without Borders, in light to performance indicators set by MSF and the Sphere minimum standards. Methods: This was a descriptive retrospective study using routinely collected programme data of children admitted with severe acute malnutrition between May 2010 and November 2011. Kamrangirchar is an urban slum of a large migrant population in Dhaka, Bangladesh. Results: There was a total of 640 new admissions, of whom 333 (52%) were males. The median age was 18 months (Inter-quartile range (IQR) 12 - 41). 599 children had a reported nutritional outcome at discharge from ambulatory therapeutic feeding centre (ATFC), this included: cure rate of 69% with an average length of stay of 68.8 (SD ± 46.0) days and average weight gain of 3.8 g/kg/day (SD ± 2.7). The lost-to-follow-up rate was 18% and 5% reported to the programme that they will leave the slum and go back to their villages. These performance indicators did not meet the threshold level indicators set by MSF and Sphere standards. Conclusions: Our experience highlights the need for developing more adapted and contextualised indicators for as

关键词： Severe Acute Malnutrition Community Based Management nutrition outcomes Urban Slum Bangladesh

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