Treatment of SAM
At present, the only treatment protocol in India for Severe Acute Malnutrition (SAM) children is to admit the complicated cases for facility-based care. But there are only about 1200 Nutritional Rehabilitation Centers (NCRs) and these are not enough to treat so many sick children. 90% of SAM cases need not go to a facility-based care and can be treated at the community level through a Community-based Management of Acute Malnutrition (CMAM) programs using Ready-to-use Therapeutic Food (RUTF), which is the universally accepted treatment protocol recommended by UNICEF & WHO for uncomplicated SAM children. CMAM is a treatment protocol wherein the caregivers of the child are trained in proper nutritional habits, hygiene and breastfeeding practices. The child is provided emergency nutritional supplement in the form of RUTF for 8-12 weeks and medicines to treat any illnesses like diarrhoea and oedema which are found in many SAM children. RUTF is a temporary measure and do not interfere with the taste and dietary preferences of the child in the long term.
CMAM programs using emergency RUTF have been successful in saving lives of SAM children in various countries in Africa, Asia and independent pilot projects in various Indian states like Rajasthan, Gujarat, Bihar, MP and Jharkhand. In Rajasthan, a recovery rate of 70.4% was recorded and mortality rate was brought down to 0.1% under the state POSHAN program using RUTF. However, the final guidelines on CMAM are still pending.