3. Management of acute malnutrition and micronutrient deficiencies
Acute malnutrition and micronutrient deficiencies are associated with an increased risk of morbidity and mortality for affected individuals. Therefore, when such prevalence or risk is high, it is necessary to ensure access to services which both correct and prevent undernutrition. The impact of these services will be considerably reduced if the underlying causes of undernutrition are not addressed simultaneously through other interventions to support health, WASH, food transfers and food security.
Moderate acute malnutrition can be addressed in a number of ways. In disasters, supplementary feeding is often the primary strategy for prevention and treatment of moderate acute malnutrition and prevention of severe acute malnutrition. This may be blanket or targeted depending on the levels of acute malnutrition, vulnerable population groups and risk of an increase in acute malnutrition. The indicators in Management of acute malnutrition and micronutrient deficiencies standard 1 refer primarily to targeted supplementary feeding. While there are no defined impact indicators for blanket supplementary feeding, monitoring of coverage, acceptability and rations provided are important.
Severe acute malnutrition is addressed through therapeutic care which can be delivered through a variety of approaches. Community-based management of acute malnutrition should be the preferred approach where conditions permit. Programmes addressing severe acute malnutrition should encompass community mobilisation (including effective communication, active case-finding, referral and follow-up), outpatient treatment for severe acute malnutrition without medical complications and inpatient management for those with medical complications or young infants.
Micronutrient deficiencies are difficult to identify in many contexts. While clinical signs of severe deficiencies may be easiest to diagnose, the greater burden on the health and survival of populations may be sub-clinical deficiencies. Where micronutrient deficiencies are known to have been prevalent in the population, it may be assumed that this could be exacerbated by the disaster. These deficiencies should be tackled using population-wide interventions and individual treatment.