Community-Based Management of Acute Malnutrition (CMAM)
CMAM in Sokoto State (2014-2015)
Nigeria has an average prevalence of global acute malnutrition of 14%, which is higher than the Sub-Saharan average of 9%. As a response to this, ACF, UNICEF and other partners, in close collaboration with FMoH introduced the Community-based Management of Acute Malnutrition (CMAM), a 15-years old system of service provision that has been incorporated by many health ministries across the world. In 2009, CMAM was initially piloted in two states, Katsina and Yobe, in 30 treatment sites. ACF started its activities in Nigeria in 2009 with full support for CMAM programme. After some years of its introduction, CMAM is facing a new set of challenges. Whereas its geographic presence has impressively improved, it still has to deliver better outcomes, both in terms of its total admissions and in terms of the rate of cure that it can provide as well as awareness about the programme in the states where it is currently being offered.
CCSI was engaged to provide a communication strategy that could help improve the visibility and awareness of CMAM services in two LGAs in Sokoto state. The goal was to increase total coverage of CMAM by improving the way communities participate in the programme through a better identification of acute malnutrition cases, a better referral to existing facilities with CMAM services and, overall, an improved knowledge about malnutrition and its treatment. The campaign involved the development of communication strategy and SBCC materials for both print and electronic channels. While a forty-man community volunteer were recruited and trained for community mobilisation activities, the radio spots and radio magazine programmes served to complement the community mobilisation activities. The campaign was a short one and has come to a close while end of project evaluation result showed there was an increase in awareness of malnutrition and traffic to facilities where CMAM services were offered.
CMAM Advocacy 1 (2015-2016)
UNICEF and other partners, in close collaboration with FMoH introduced the Community-based Management of Acute Malnutrition (CMAM) in in Nigeria in 2009. At inception, CMAM was piloted in two states, Gombe and Kebbi, in 30 treatment sites. The programme has grown over the last few years across the 11 northern states, with more than 320,000 children admitted for treatment in 2014 alone. UNICEF Nigeria continues to support Government of Nigeria in strengthening and scaling up a sustainable CMAM in Adamawa, Bauchi, Borno, Gombe, Jigawa, Kano, Katsina, Kebbi, Sokoto, Yobe, Zamfara and Kaduna states which are the most affected areas in malnutrition. The programme was implemented in over 600 sites and 97 LGAs (across the 12 northern states. The success of CMAM depends on the availability of Ready-to-Use Therapeutic Food (RUTF).
To maintain the tempo and sustain the efforts to increasing government funding, especially for the procurement of RUTF, some state specific advocacy strategies were required to engage the attention of states and to guide them. It was envisioned that, advocacy strategies, which were customized for the northern focal states, would inform the development of a comprehensive National CMAM advocacy strategy which to date have not been achieved. It was also hoped then that the successful implementation of these strategies would set a strong foundation for an impactful SBCC campaign around malnutrition issues and especially RUTF which is the basic ingredient for CMAM services.
Advocacy to build support for an enabling environment for nutrition is essential at the national, state, local government and community level. This would help institutionalize the implementation of CMAM program in Nigeria. This was where CCPN came in to support the development of advocacy strategies and materials for six northern states of Borno, Jigawa, Kano, Katsina, Kebbi and Sokoto states in 2015.
The partnership with CCPN put in place specific advocacy strategies with an initial focus on the above mentioned six states. The overall goal of the partnership was to increase funding and financial support and a supportive policy environment for ensuring access to CMAM services at community level.
CMAM Advocacy 2 (2017-2018)
Advocacy to build support for an enabling environment for nutrition is essential at the national, state, local government and community level. This would help institutionalize implementation of CMAM program in Nigeria. The partnership with CCSI started in 2014 to put in place specific advocacy strategies with an initial focus on six states of Borno, Jigawa, Kano, Katsina, Kebbi and Sokoto. The overall goal of the partnership was to increase funding and bridge the financial gap while putting in place a supportive policy environment for ensuring access to CMAM services at community level. Two years after the development of advocacy strategies and materials in the six states, it was necessary to review how far the strategy and materials have helped increased visibility for CMAM in the six states. It was also to see how the materials have been utilized as an advocacy tool to increase government commitment toward procurement of RUTF and funding for CMAM.