Since 2007, the Community–based treatment of Acute Malnutrition (CMAM) approach has resulted in a significant increase in the number of children with uncomplicated SAM who are successfully treated in an outpatient health centre using Ready to Use Therapeutic Food (RUTF). More than 70% of children treated are cured but less than 1 out of 5 of children affected are able to access the treatment they need.

From 2014 to 2016 with the Ministry of Health and the Agan Kan University worked with 75 Lady Health Workers (LHWs). The objective was to test an innovative approach to diagnose and treat children with SAM outside of the health facilities. Phase 1 of the study was successful, with results showing that:

  • the coverage assessment was the same in the control and intervention approach,

  • in both groups, cured, defaulters and deaths rates respect the Standard Sphere,

  • quality of care provided by LHWs was high,

  • the intervention was cost-effective compared to the traditional approach in health facilities.


The use of Lady Health Workers to diagnose and treat severe acute malnutrition outside of the health facilities has the potential to become a global approach that could be tested and delivered in other countries and contexts. With this aim, Action Against Hunger is actively working to contribute to the global evidence base with three additional pilot studies testing this approach in Kenya, Mauritania and Niger.

This evidence suggested that adequate training and on-the-job support are critical to ensuring acceptable levels of quality in the delivery of SAM treatment and other services. More research is needed to model the intervention in Pakistan.

DONORS: innocent foundation

PARTNERS: Ministry of Health and Aga Kan University

CONTACT: Pilar Charle Cuellar

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