Adaptations to the Management of Acute Malnutrition in the Context of COVID-19

The COVID-19 pandemic presented critical challenges to the management of acute malnutrition in children under five. To address these challenges, governments and organizations adapted their approaches for community-based acute malnutrition detection and treatment following global guidance, with the aim of enabling continue life-saving service provision while limiting the spread of COVID-19. Many of these adaptations, sometimes referred to as ‘simplified approaches’ to acute malnutrition treatment, were piloted or trialed before the pandemic to improve detection and treatment. However, the mass rollout of these adaptations as the pandemic escalated in early 2020 presented a unique opportunity to examine them at a scale larger than ever before.

Action Against Hunger USA, in collaboration with the United States Agency for International Development (USAID), the United Nations Children’s Fund (UNICEF), and the US Centers for Disease Control (CDC), undertook a mixed methods study to (1) map which adaptations to community management of acute malnutrition (CMAM) programming were made and where; and (2) document and synthesize operational lessons learned. This report presents the findings from this study, with the aim of contributing both to programmatic decision-making during the pandemic and to the evidence base on simplified approaches. The report offers an overview of the study methodology; discusses themes and takeaways consistent across adaptations; and then delineates lessons learned for five common adaptations: Family MUAC; a reduced frequency of follow-up visits; modified admission and discharge criteria; modified dosage of therapeutic/supplementary foods; and providing treatment when facilities were inaccessible.