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Dr GUERO H.DOUDOU Maimouna
REPUBLIQUE OF NIGERCMAM/SUN Conference14th-17th November 2011Addis Ababa, Ethiopie
Scaling up community management ofacute malnutrition and scaling up nutrition
MANAGEMENT OF ACUTE MALNUTRITIONIN NIGER:
A COUNTRYWIDE PROGRAMME
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Niger, Management of acute malnutrition : a countrywide programme
≤ 10 %
10 % - 15 %
≥ 15 %
Prevalence of SAM : 3,1%Prevalence of MAM : 12,3%
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Current coverage CRENI/CRENAS
50 CRENI(coverage 100%)
850 CRENAS(coverage 92%)
1000 CRENAM(coverage 47%)
CRENI = in-patient (SAM)CRENAS = out-patient (SAM)CRENAM = out-patient (MAM)
Niger, Management of acute malnutrition : a countrywide programme
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- Establishment of a core group (coordination)
- Quick survey of the nutritional situation and identificationof vulnerable areas- Development of a national protocol for management ofacute malnutrition- Distribution of humanitarian NGOs; supplies, training,M&E
Niger, Management of acute malnutrition : a countrywide programme
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-2006 to 2008:
- Continuation of CMAM services- Strengthen nutrition coordination in all regions andyearly nutrition surveys and studies- Transfer of knowledge of NGOs to government services- Establishing primary health care facilities- Introduction of free health care for vulnerable groups(U5 children and pregnant women)
2009 to 2010:
- another food security crisis; upgrade of nutritiondivision to directorate level
- Wider scale-up of CMAM with improved coordinationat all levels
Niger, Management of acute malnutrition : a countrywide programme
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-
2011:
• Food security and nutrition symposium established bygovernment (SISAN) developing political and 5 yearstrategic document for nutrition
• Financing through internal and external sources
• budget line dedicated for nutrition within the healthbudget
• Join the SUN and REACH international movements
• Recently, the President launched an initiative tostrengthen food nutritional security in the country (3N)
• Linkages improved between other public healthprogrammes (vaccination, IMCI and HIV/AIDS)
Niger, Management of acute malnutrition : a countrywide programme
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Results: Cure rates by region Jan-Oct2011 (of 230,907 SAM admissions)
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Default rates by region Jan-Oct 2011
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Death rates by region Jan - Oct 2011
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1. Increasing political commitment for nutrition
2. Strong leadership from ministry of publichealth for coordination
3. Technical support and assistance frompartners (UN, NGOs, etc)
4. Development of longer-term strategies toaddress malnutrition
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• Challenge 1: How to ensure and maintainquality care in all treatment centers(especially recruiting enough trained healthstaff);
• Challenge 2: How to sustain adequate suppliesof expensive therapeutic products (currentlyprovided by partners);
• Challenge 3: how to scale-up MAMprogrammes across the whole country
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• CMAM success relies on strong governmentvision and commitment for strategy,coordination and resource mobilisation
• Strong government coordination is vital,especially when many partners are involved
• Standardisation of treatment is key to ensureequity in treatment and comparable data
• Partners prefer to focus on treatment notprevention. There is a need for morepreventative programming
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Next steps
• Adoption of national nutrition plan
• Implementation of SUN and REACH
• Expand programmes across the whole country
• Development of national preventativenutrition strategy based on ‘best practices’
• Build community capacity for healthybehaviours
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Nutrition is an integrated part ofdevelopment; there is no
development without goodnutrition
Acknowledgements
•Government of Niger
•UNICEF – Professor Eric Ategbo
•ENN – Emily Mates
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MERCI Thank you