African Journal of Public Health and Health Systems | 05 May 2014
Evaluating the Impact of a Community-Based Management Programme for Severe Acute Malnutrition with Ready-to-Use Therapeutic Food on Recovery Rates in Chad’s Kanem Region
M, a, h, a, m, a, t, S, a, l, e, h, ,, H, a, r, o, u, n, A, d, o, u, m, ,, F, a, t, i, m, é, A, b, a, k, a, r, ,, A, ï, c, h, a, N, o, u, r
Abstract
Severe acute malnutrition is a critical public health challenge in the Sahel. Chad’s Kanem Region reports some of the highest global prevalence rates. Facility-based treatment has historically been limited by access and coverage barriers, prompting a need to evaluate community-based approaches. This study evaluated the impact of a community-based management programme for severe acute malnutrition using ready-to-use therapeutic food on recovery rates among children aged 6–59 months in the Kanem Region. A quasi-experimental design compared outcomes between intervention and control areas. Community health workers screened, diagnosed, and treated uncomplicated cases at home with ready-to-use therapeutic food. Routine monitoring data from a consecutive sample of enrolled children were analysed to determine recovery, default, and mortality rates against international SPHERE standards. The programme achieved a recovery rate of 81.4% in the intervention group, significantly higher than the 65.2% observed in the control group receiving standard care. The default rate was 11.6%, and the mortality rate remained below the 10% emergency threshold. The community-based management programme using ready-to-use therapeutic food significantly improved recovery rates for severe acute malnutrition in a high-prevalence, hard-to-reach setting. This model effectively overcame key barriers to treatment access. Scale-up of this community-based model is recommended across similar contexts in Chad. Integration into national health policy and strengthening of ready-to-use therapeutic food supply chains are essential. Further operational research should focus on improving coverage and reducing default rates. severe acute malnutrition, community-based management, ready-to-use therapeutic food, recovery rate, Chad, child health This study provides original empirical evidence on the effectiveness of a decentralised, community-led model for managing severe acute malnutrition in a protracted crisis setting, informing policy and programme design.