As mentioned in the previous post, for the past three years, Food for Thought has been thrilled to support Concern Worldwide’s therapeutic feeding centers in Ethiopia through the Walk for Plumpy’nut. The last post highlighted Concern’s Community Therapeutic Care (CTC) model. Now, as promised, Plumpy’nut Press is honored to feature Concern’s work with Plumpy’nut and its incredible dedication to reducing the suffering and working towards the ultimate elimination of extreme poverty in the world’s poorest countries. Below is an interview completed by the staff at Concern Worldwide.
How does Concern Worldwide diagnose severe malnutrition?
Children with acute malnutrition are usually identified by Community Health Volunteers using Mid-Upper Arm Circumference (MUAC) tapes and by checking the presence of oedema. Children with MUAC measurements less than 125 mm (note: cut-off point may vary based on country and program) are referred to the treatment facility where they undergo further assessments and treatment.
Following a diagnosis of severe malnutrition, what treatment does the child undergo?
The majority of the children with severe acute malnutrition are treated with RUTF and some medications such as antibiotics, vitamin A, etc. The small proportion of children with severe acute malnutrition and medical complications are treated in inpatient settings based on special protocols.
Prior to the implementation of Plumpy’nut, how did Concern Worldwide treat severe malnutrition?
Until RUTF was invented and CTC model was developed, children with severe acute malnutrition were being treated in inpatient facilities using special therapeutic milks and other medications.
Does Concern use any other Plumpy products (Supplementary’Plumpy, Plumpy’doz, Nutributter, Plumpy’soy)?
Concern primarily uses Plumpy’nut but we use other Plumpy products as well in our programs. In Rwanda, for example, Plumpy’doz was used initially in 2008 for treatment of acute moderate malnourished children without complication at the community level but has now discontinued its use (due to costs and to conform with the recently updated national nutrition protocol). Currently the program uses Supplementary Plumpy to treat acute moderately malnourished children in the community by trained volunteer mothers.
How successful has Plumpy’nut been in Concern’s work to fight childhood malnutrition?
The invention of RUTF and its use in CTC/CMAM programs have significantly increased Concern’s capacity to identify and treat children with severe acute malnutrition as most children are treated at home. Concern has successfully treated tens of thousands of children in its CTC/CMAM programs around the world using RUTF. Concern will continue to use CTC/CMAM as its core approach to treat malnutrition while exploring other models for preventing childhood malnutrition.
How do children react to the taste of Plumpy’nut?
Most children with severe acute malnutrition respond to RUTF treatment very well. They usually like the taste and consistency of Plumpy’nut.
Are there any stories about specific children who were saved by Plumpy’nut that you would like to share?
Concern is helping the Ethiopian Government change its national health policy to include Community-based Therapeutic Care (CTC). Asaw Jadoo is one of thousands of Ethiopian children whose life has been saved by this innovative treatment. In 2007, Asfaw lost all appetite, and his face and limbs began to swell. His mother took him to the Concern-supported Enseno rural health center, where he was diagnosed with severe acute malnutrition. He was immediately referred to Butajira hospital. Once Asfaw’s condition became stable, he was discharged from the hospital and admitted to the outpatient CTC program in his community. His nutritional and health status are checked weekly, and community health volunteers give his mother a supply of ready-to-use therapeutic food that she uses to treat Asfaw at home—all of this is done in accordance with the national treatment guidelines developed by Concern.
Are there any regions that Concern focuses on most heavily for childhood malnutrition relief?
While majority of Concern’s CTC/CMAM programs are in Africa, Concern’s humanitarian and development programming in general is based on needs and targeting the extreme poor.
Has Concern introduced any new innovative ways or programs, like CTC, to treat malnutrition? Is Plumpy’nut the preferred RUTF?
Concern continues to invest resources in finding solutions to address childhood malnutrition. We are currently engaged in developing new models and finding ways to prevent malnutrition.
One example of Concern’s innovation to prevent malnutrition is the Realigning Agriculture to Improve Nutrition (RAIN) project. Concern and the International Food Policy Re-search Institute (IFPRI) have recently embarked on a partnership to design and rigorously evaluate a project to prevent stunting in young children by realigning a package of agriculture-based interventions to specifically improve nutrition components. The program will work to understand and address the underlying causes of undernutrition in one of Concern’s existing countries (Zambia, Ethiopia or Uganda). Like many traditional food security interventions, the RAIN project aims to effectively improve food availability and access. One of the defining differences of the RAIN approach will be the emphasis on understanding the key impact pathways linking agriculture and other interventions to improved nutritional outcomes for children under two years of age and actually designing the core agricultural interventions to achieve those outcomes. In this way, RAIN aims to go beyond the traditional objectives of food security programs (e.g. increased yields, reported increase in meals per day) and to focus on measureable improvements in nutrition security. Critical issues such as the nutritional profile of crops, methods of food storage and preservation, constraints and opportunities for optimal infant and young child feeding, and the decision making power and workload of women will be carefully considered during the design phase. Essential components will be incorporated to address these issues, including promotion of nutritious crops/small livestock, women-focused appropriate technology, intensive behavior change communication, links with health care an empowerment of women.
Plumpy’nut is the main RUTF used in majority of the Concern’s CTC/CMAM programs.
What should readers do if they would like to donate to Concern?
There are many ways to support Concern’s emergency and development programs in the 28 countries that Concern works in to alleviate suffering in the poorest populations. To make a donation online, please go to http://www.concernusa.org/Public/DonateOptions.aspx
For information on Concern’s current response to the Pakistan floods visit: www.concernusa.org/pakistanappeal
Concern also launched our Houses for Haiti campaign. Check back later for details on how you can help rebuild Haiti’s homes: www.concernusa.org/housesforhaiti
Is there any other information about Concern that you would like to share?
Right now, Concern US has launched our Women Can’t Wait campaign which features videos and case studies on women marginalized farmers and a petition urging leaders to give women a greater voice in the fight against hunger. We hope to bring signatures to the MDG Summit taking place in New York in September. Help us sign the petition, go to: www.concernusa.org/unheardvoices
For students and teachers, Global Concerns Classroom (GCC) is a global education program of Concern US which offers free resources and services to secondary schools interested in learning about global issues and taking part in fighting poverty. For more information, go to www.concernusa.org/GCC.
For more information on Concern’s work, go to www.concerusa.org.