Concern Worldwide’s Community Therapeutic Care

For the past three years, I’ve been honored to work with Concern Worldwide through the Walk for Plumpy’nut.  All proceeds from the walk, including this year’s event on October 9th, have been used to support Concern’s therapeutic feeding centers in Ethiopia.  This past March, Concern was honored for the success of its groundbreaking Community Therapeutic Care (CTC).  The next Plumpy’nut Press post will feature Concern’s work with Plumpy’nut, but first, I wanted to share with readers how Concern developed the CTC program.  Below, representatives from Concern Worldwide explained the background behind their innovative program used to treat children suffering from severe malnutrition.  Read on for more information about this highly successful feeding initiative!

Until late 1990s, the only option available for treating children with severe acute malnutrition was hospital based care where malnourished children were admitted in an inpatient facility along with caregivers (usually mothers) and treated using therapeutic milk for several weeks. This caused several problems for the children and their families. For example, when caregivers are away from home for extended periods of time, this affects their livelihood and, especially when the caregivers are mothers, this puts the other children at home at increased risk of becoming malnourished. Additionally, access to these treatment facilities was also limited as they required highly trained technical staff and supplies to operate. This was even a greater problem during large scale emergencies.

Photo courtesy Concern Worldwide US

The CTC model was developed to address the limitations of this center based care for malnourished children. In CTC, the majority of the malnourished children are treated at home using specially formulated Ready to Use Therapeutic Food (RUTF) and only a small proportion of malnourished children are treated in inpatient facilities, often called Stabilization Centers (SC). Often, these children are discharged within a few days and continue treatment at home. Severely malnourished children are identified early by Community Health Volunteers and referred to highly decentralized treatment facilities, called Outpatient Therapeutic Center (OTP), where they get a weekly supply of RUTF and routine medications and continue treatment at home. CTC was made possible by the development of RUTF. The Movement within the ‘Triage of Care’ illustration highlights this community-based model.

The RUTF used in majority of the Concern’s CTC/CMAM programs to treat children with severe acute malnutrition is Plumpy’nut.  CTC has been highly successful primarily because of its high coverage and easy access. Home based treatment has helped families to get treatment for their malnourished children without causing adverse affect on their livelihoods and other children. Early detection and referral mechanism has helped children get treatment before complications are developed. The community mobilization component of the CTC program has helped understand community dynamics and minimize barriers to the program.

Concern has been a global leader in the development of CTC, which over the years has evolved and become Community-based Management of Acute Malnutrition (CMAM). Working in partnership with Valid International, Concern piloted this new approach in three countries in 2002/2003, at a time when treatment was limited to an insufficient inpatient-only model. The innovative approach, which has proven successful at achieving high coverage, early detection and effective treatment of acute malnutrition (wasting and nutritional oedema), has now been widely adopted as best practice by the UN (UNICEF, WHO, WFP) and the majority of governments and non-governmental agencies.

For those of you with a little more time on your hands, take a look over Concern’s Special Supplement guide to their CTC.  Check out Concern Worldwide US online to learn more about their phenomenal life-saving work around the world!


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