Evidence-Based Recommendations for the Assessment of Severe Acute Malnutrition in Children Aged 6-59 Months in the Central African Republic

Abstract

Thirty-five percent of mortalities in children under the age of five can be attributed to malnutrition (World Health Organization (WHO), n.d.). Nearly 24 percent of children less than five from 2008-2012 in the Central African Republic were moderately or severely underweight and nearly eight percent suffered from severe or moderate wasting (The United Nations International Children’s Emergency Fund, 2013). As a result of recent sectarian violence which began with a coup in March 2013, the Central African Republic is facing a nutrition crisis. As a result, an estimated 28,000 Central African children under the age of five are predicted to be affected by severe acute malnutrition (SAM) and 75,000 from moderately acute malnutrition in the year 2014 (The Assessment Capacities Project, 2014). The WHO (2007) defines SAM in children aged 6-59 months as a low weight-for-height/length below -3z scores/standard deviations (SD)of the median WHO growth standards (WHO, 2006), the presence of nutritional edema, or a mid-upper arm circumference (MUAC) less than 115mm. Uncomplicated cases of SAM may be treated on an outpatient basis through community feeding programs. The limited access to resources such as training materials, protocols, charting systems, accurate scales, height boards, growth charts, or measuring tapes in developing countries hinders the utilization of objective admission, assessment, and discharge criteria. The purpose of this project is to develop practical and evidence-based recommendations for assessing the nutritional status of children aged 6-59 months for a community based nutrition program in the Central African Republic in order to establish evidence-based standards for screening, admission, monitoring, referral, and discharge criteria

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