Access For All. Volume 1: Is community-based treatment of severe acute malnutrition (SAM) at scale capable of meeting global needs
This report, the first in a three part series, offers a comparative assessment of the performance and effectiveness of the model during two distinct periods of its development: from 2001-2006 when the majority of community-based treatment projects were implemented by NGOs; and from 2007-2013 when many community based treatment programmes were integrated by ministries of health into regular health services.
Publication date
1st January 2013
Author(s)
Coverage Monitoring Network
For each period, three components of the community-based treatment model are assessed: the capacity of treatment services to successfully cure SAM cases, their capacity to reach the highest proportion of the affected population (coverage) and their cost-effectivenes.
The three main conclusions:
- Community-based treatment models deliver exceptional clinical outcomes. The median cure rates of community-based models in the 2001-2006 and 2007-2013 periods were 80% and 84% respectively. SAM cases admitted into treatment services today are as likely to be successfully cured today as they were a decade ago.
- In areas where SAM services are available, only a third of affected cases actually access treatment. The analysis shows that whilst high coverage can be achieved by community- based SAM treatment, the conditions necessary to do so are seldom met. The capacity of treatment services to meet global SAM needs depends on coverage being significantly and consistently improved.
- Community-based models are more cost-effective than in-patient models. Cost-effectiveness analyses show that some community-based models were two times more costeffective than in-patient models. In spite of their dependency on context-specific operational factors, recent evidence suggests that MoH delivered community-based SAM treatment services continue to be cost-effective interventions.