?FAMILY-MUAC IN THE CONTEXT OF COVID-19

WEBINAR

UNICEF

June 2020

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STRUCTURE OF THE WEBINAR

COVID-19COVID-19

PART I❖ Why using Family-MUAC❖ Interest of the approach during COVID-19 context❖ Global evidence on its role in early identification of wasting

PART III❖ ESAR: Kenya and its current experience of the Family-MUAC approach

during COVID-19 context

PART II❖ Overview of current experiences and adaptations to date in WCARO❖ WCAR: Nigeria and its current experience of the Family-MUAC

approach during COVID-19 context

PART IV (Annex)❖ Family-MUAC implementation and adaptations during COVID-19

context (trainings and resources)

?Part I

Why Family-MUAC? &Global evidence on its role in early identification of wasting

UNICEF

?

Why Family-MUAC?

The 'Family MUAC' approach, also known as MUAC for mothers or Mother-MUAC, trains mothers and other caregivers to identify early signs of malnutrition in their children using a simple to use Mid-Upper Arm

Circumference (MUAC) tape.Mothers (or other family members), can do this task as effectively as Community Health Workers (CHWs) and

malnutrition is expected to be detected earlier, and to lead to less hospitalizations.By shifting screening from health workers to mothers or care givers, Family MUAC has the potential to save

money, to save valuable time for CHWs, to support and empower the community

https://www.nowastedlives.org/news-blog/2019/2/5/family-muac-community-of-practice-sharing-tools-on-an-innovative-approach-to-reach-more-children-with-acute-malnutrition

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Why using Family-MUAC during COVID-19 context?

With the spread of the COVID 19 pandemic and the related restricted measures impacting living conditions of the population (lockdown, mobility’s restrictions…), use, access and perception of health services may be

negatively impacted. Mass screening campaigns are likely to be suspended in most of the countries, based on recommendations to avoid physical contacts, gathering and/or to use IPC measures after each contact, which

can be resources demanding.

Detecting malnutrition at the household level can help overcome these barriers.Family-MUAC is one of UNICEF and the Global Technical Advisory Mechanisms priority actions to support

preparation and response to acute malnutrition in the context of COVID-19 : Management of child wasting in the context of COVID-19

UNICEF Niger, PB-mereshttps://unicefniger.tumblr.com/post/178727539584/pb-m%C3%A8re-un-des-moyens-les-plus-rentables-de

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Why Family-MUAC: Global evidence on its role in early identification of wasting

UNICEF WCARO conducted a rapid review (April-June 2020) on the effectiveness of screening of Acute Malnutrition at community-level (Family-MUAC)

41 documents (papers, published evidence, online publications, unpublished evidence/operational findings) have been collected through online databases, websites and

by direct contacts with implementers

Based on the assessment of these outcomes

✓ the quality of detection (ability of mothers to correctly detect and diagnose

malnutrition and edema)

✓ the timing of detection (early detection)

✓ the quality of treatment (fewer hospitalization/faster recovery)

✓ its impact on coverage and the sustainability of the approach.

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Why Family-MUAC: Quick assessment of the evidence

Results on the quick assessment of the availableevidence related to Family-MUAC

Little peer-reviewed evidence butoperational findings present valuable documentation on the effectiveness and implementation of the approach in different contexts

Peer-reviewed studies mainly focused on

demonstrating the ability on mothers (compared to

CHWs) to perform MUAC measurements. Some include

data on the timing of detection (early detection) and

the quality of treatment (fewer hospitalizations).

Peer-reviewed evidence has been produced in 3 countries: Kenya (ACF), Niger

(ALIMA) and Burkina Faso (ALIMA)

2

Covering all regions of the African continent and including data on the quality of screening (over time), quality of treatment (faster recovery) and the sustainability of the approach (context, trainings, tools, M&E mechanism and cost-effectiveness)

4 ALIMA (WCARO), ACF and GOAL (ESARO) are the 3 main

producers of (online available) evidence but ALIMA

produced alone half of the peer-reviewed studies and

communicated more on the different possible outcomes

of the approach

17 countries covered by the available evidence on the Family-MUAC

approach, mainly in WCARO.

1

3

?Based on peer-reviewed studies and operational findings and it is clearly assessed that mothers/caregivers can do correct MUAC measurements in different contexts and/or are not inferior to CHWs

1

But there are 2 main limitations:- this ability tends to decrease over time after the last

training/refreshment - in setting with low prevalence of edema, ability of

mothers to detect edema seems to be lower

2

Why Family-MUAC: Results on early detection & treatment

One study (Ale et al, 2016) demonstrated an effective earlier detection (higher median MUAC at admission) and fewer admissions to hospitals in Niger (lower inpatient care needed). Among operational findings, itremains mainly presupposed or suggested by implementers/researchers that the Family-MUAC approach can lead to an earlier detection but there are some promising results (need for standard/feasible indicators)

3

There is little evidence on the fact that a Family-MUAC approach can improve the quality of treatment by reducing time needed for it and by fasting recovery. But one study (Daures et al, 2020/ALIMA) showed for the first time that children of a caretaker who received MUAC training were more likely to recover, which could be explained by a better care-seeking behavior resulting from such trainings.

4

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Why Family-MUAC: Results on coverage

According to the evidence, the Family-MUAC approach can lead to an improved coverage of screening. It has been shown that a vast majority of mothers are reported to take MUAC measurements several times a month (more than CHWs)

5Ale et al, 2016 (ALIMA) in Niger proved that coverage can be similar whether it is a zone where mothers are screening or where CHWs are in charge.

6

Coverage

?Part II

Overview of current experiences and adaptation to date in WCARO&WCAR: Nigeria and its current experience of the Family-MUAC approach during COVID-19 context

UNICEFWest and Central Africa Regional Office

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Family-MUAC before COVID-19

“In order to achieve early identification of children with severe acute malnutrition in the community, trained community health workers and community members should measure the mid-upper arm circumference of infants and children who are 6–59 months of age and examine them for bilateral pitting edema.”WHO: Updates on the management of severe acute malnutrition in infants and children. 2013

This approach fits within existing normative guidance on how to manage Acute Malnutrition.

➢ In Mali, a revision of the protocol in 2017 resulted in community members being cited as instrumental in the detection process, with mothers being specifically identified as important targets for training.

➢ In Mauritania, the approach has also been integrated into national policy, with over 18,000 family members having received training. Likewise, the national policy in Niger endorses this approach.

➢ In Burkina Faso the Nutrition Division has standardized the approach by annexing it into national protocols to ensure the approach can be delivered at scale.

Some countries in the WCAR have adapted protocols (before COVID-19)

Multiple countries in the Sahel have already adapted their protocols to include community member training on MUAC to facilitate early detection and treatment.

❖ Global level

❖ Regional level

National adaptations to protocol in the WCAR for Family-MUAC

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Family-MUAC during COVID-19

This approach has been recommended by the GNC-UNICEF-GTAM for the prevention and management of wasting during COVID-19Intensify efforts to strengthen the capacity of mothers and caregivers to detect and monitor their children’s nutritional status using low-literacy/numeracy tools including Mid-Upper Arm Circumference (MUAC) tapes.

❖ Global level

« Briefing individuel de chaque acteur communautaire sur la prise du PB pour que ces acteurs communautaires briefent les mères qui assureront la prise de PB (approche PB mère). »« Prise du PB avec des bandes individuelles (laissées à la garde de la famille). »

« La mesure du PB- Périmètre Brachial est recommandé dans la communauté »« Une bande PB par enfant est recommandée (promouvoir le PB-mère) »

❖ West and Central Africa Regional level

In DRC, the Family-MUAC approach has been recommended by the Nutrition Cluster and the government for nutrition during COVID-19

Same in Mali, to avoid overcrowded health centers

« Favoriser les actions au niveau communautaire en renforçant l’approche les PB-mères pour le dépistage avec formations et suivi via les relais communautaires et via les GSAN. Avec appui de vidéos éducatives sur les PB à diffuser via les relaisPropositions d’action-clefs d’adaptations des programmes dans le cadre du COVID-19. Cluster Nutrition.

Nigeria: Context during COVID-19

February 27th: First case declared in Lagos

As of June 13th

❑ 15,682 confirmed cases COVID-19 ❑ 5,101 cured and 337 deaths❑ Most affected country in WCA

Measures taken❑ Ban on interstate movement❑ Complete lockdown in some states❑ No non-essential international travel❑ Ease of lockdown in most states by June ❑ Laxity on Covid19 IPC measures by gen. population

Socio-economic impact ❑ Limited access to food by the population❑ Disruption in livelihood activities❑ Limited access to markets that are already

disrupted

CO Nutrition programme COVID proofing (1)

❑ Working with FMoH to adapt technical guideline for Covid-19 sensitiveNutrition programming

❑ Developing Information, Education and communication materials❑ Supporting to MoH in provision PPE to health frontline workers❑ Procuring and prepositioning Ready-to-Use Therapeutic Food and

Therapeutic Milks at strategic locations to address additional needs❑ Change in treatment and reviewing schedule: Admission every day and

provision of two weeks ration of RUTF to reduce the frequency of visits totreatment centre and promotion of social distancing

❑ Providing training and technical support to mothers and caregivers on“Mother MUAC”, an alternative approach to active case finding topromote self-household malnutrition screening and referral of identifiedSAM cases

CO Nutrition programme COVID proofing (2)

❑ Virtual coordination meetings with Nutrition partners at the state level❑ Adapting training techniques: Limiting meetings among community

nutrition mobilisers (CNMs) to a max of 10, keeping safe distanceamong them

❑ Use of more graphic and visual communication in training to limittalking, exchange of written materials and personal contact

❑ Developing and distribution of Covid-19 Information, Education andcommunication materials

❑ Procuring and prepositioning Ready to Use Therapeutic Food andTherapeutic Milks at strategic locations to address additional needs(two weeks ration of RUTF)

Background on Mother MUAC in NE Nigeria

❑Was initially meant to serve as a transition phase from mother-to-mothersupport groups to community mobilization for screening in Dec. 2019

❑The COVID-19 outbreak prompted adoption of mother MUAC in earlyMarch 2020

❑Planning started in February 2020

❑Pilot in Bayo and Shani LGA, Borno State 9th – 27th March 2019❖25,123 caregivers attending MMSGs (F; 23,084, M; 2,039) were trained on Mother

MUAC approach in Bayo and Shani LGAs in March;

❑Scale up in Borno and Yobe through April and May 2020.❑285,468 caregivers (F;229,820, M;55,648) trained in 15 LGAs in Borno state and 5

LGAs in Yobe state by the end of May 2020

LGAs covered by the scale-up

Ensuring sufficient stock of MUAC Tapes

LGA in Borno MMSG members MUAC Tapes (pieces distributed to mothers in March 2020)

Konduga 2,193 2,193

Jere 10,804 10,804

Bama 920 920

Mobbar 590 590

Ngala 1,862 1,862

Gwoza 1,073 1,073

Kalabalge 311 311

Dirkwa 694 694

Kukawa 853 853

MMC 10,741 10,741

Chibok 6,420 6,420

Kwayakusar 8,490 8,490

Hawul 7,680 7,680

Biu 9,795 9,795

Askira Uba 6,217 6,217

Bayo 12,138 12,138

Shani 18,075 15,000

Yobe 119,452 144,450

218,308 240,231

Why the Scale-up of Mother MUAC

❑Community based management of acute malnutrition in NE Nigeria largely relies on CNMs toconduct MUAC screening of children and referral for treatment of SAM and MAM.

❑This requires the CNMs to conduct MUAC screening either house-to-house, care support groupsor health facility screening

❑In the context of Covid-19, this approach significantly increases the risk of spreading the infectionand violates the Nigeria National guideline for prevention and control of Covid-19.

❑To maintain early detection and referral of undernourished children for treatment andinvolve the mother in monitoring the nutrition status of the child, the Mother MUACapproach was scaled up from 2 LGAs to 20 LGAs directly supported by UNICEF.

❑The Mother-MUAC approach reduces exposure between the nutrition service providers andbeneficiaries.

❑Supports restricted movement and gatherings, social distancing and other Covid-19 infectionprevention and control approaches

❑Mother-MUAC approach has been used as a support group phase out approach forcaregivers who have attended support group for over 18 months

How the Scaling-up was done? (1)

• Working with the govt and launch of sector strategy on Mother-MUAC

• Dissemination of lessons learnt from Sector partners in the region

• Distribution of MUAC tapes to all Nutrition partners for the scale up

• Training of State supervisors and CMNs at the LGA level

• ALIMA ToT guidelines and UNICEF Mother MUAC strategy were used

• Roll-out of training for CNMs and their supervisors at LGA-level

• Scaling the same to community level through mother-to-mother support group members

• The CNM and members of MMSGs serve at the link between community and health facility

• It was first in the hard-to-reach and newly accessed LGAs, then to the rest of the LGAs directlysupported by UNICEF

•

Training: ❑ Mother MUAC approach and principles ❑ Led by trained CNM and their supervisors❑ Training of caretakers in batches of ten❑ Training on Covid-19 prevention❑ Use of face masks and social distancing

How the training was done❑ CNM involved in selection of mothers and caregivers

from MMSGs, Father support group attendance and Care groups

❑ Colour-coded MUAC tapes❑ CNM provided training for selected caregivers, 10 in

each batch and a distance 2 M from each other ❑ More graphics and visual train aids used

Sensitization of CNM on covid-19 and MUAC screening at Bama IDPs camp clinic. Adequate spacing between each participant was mandatory

How the Scaling-up was done? (2)

Supervisor CNMs Health workers

Borno 71(42 M; 29 F)

2,677 ( 624 M; 2,053 F)

170 (55 M; 125F

Yobe 39 (29 M; 13F)

726 (279 M, 447F)

NA

Total Male Female

Borno 166,018 33,134 132,884

Yobe 119,452 22,514 96,936

Total 285,468 55,648 229,820

Training of trainers Training of mothers/caregivers

Scaling-up Family-MUAC in NE Nigeria: Training of

caregivers

SAM admissions, before and after Scale-up

8149

8390

8810

7974

9424

7000

7500

8000

8500

9000

9500

10000

January February March April May

New Admissions by Month in UNICEF-supported LGAs in 2020NE Nigeria

-Covid-19 declared a national disaster-Inter-State movement restriction-Total lockdown (only essential services were allowed) -Training of lead trainer and CNMs initiated-The first batch of mothers trained to conduct home) screening (285,468 trained)

Challenges Opportunities

Large quantity of MUAC tapes requiredforscale up (51,740 packs required by the Sector; distributed currently)

Willingness of community members (caregivers) to actively participate in the training of MUAC mother screening

Perception by some caregivers thatthey are doing the work of CNMsmakes them expect some incentives

The current experience offers a chance to share lessons learnt to scale up the same strategy to other LGAs/regions of the country

Lack of household data tools to capture number of screening done by caregivers/mothers

May become a less costly new normal in SAM treatment programme even after COVID-19 pandemic

Inadequate quantity of IEC and preventive materials for COVID-19 prevention

Opportunity for mothers to pay attention to the general health and condition of their children

Challenges and Opportunities

Key-partners in scaling-up

❑SPHCDA, ALIMA, IRC, AAH, EYN, IMC, PLAN , Intersos

❑The partners were already implementing nutrition intervention activities in NE

❑Partners have past experience in care/support group and Mother MUAC approach

Recommendations/lessons learnt

❑CNMs/Mothers leads plays an integral part in the Mother MUAC approach.Their role in following up coaching of mothers/caregivers is critical in the scaleup

❑To avoid duplication a trained mother lead should be given just one MUACtape to train another mother that has never participated in the Mother MUACtraining in her community.

❑Active involvement of men in the mother MUAC approach is essential forhousehold/community willingness and acceptance, this is something toconsider in scale up plans

❑A robust plan to have a sufficient stock of MUAC tapes need to be in place

❑Use of the colour-coded MUAC tape is highly recommended. It helps improveaccuracy in measurements by mothers.

❑Regular follow-up on mothers to assess accuracy in measurements. We useCNMs allocated a number of households to oversee.

References

1. UNICEF Mother-MUAC Scale-up Report (2020)

2. Mothers screening for malnutrition by mid-upper arm circumference is non-inferior to community health workers: results from a large-scale pragmatic trial in rural Niger, Franck G.B. Alé, Kevin P.Q. Phelan, Hassan Issa, Isabelle Defourny, Guillaume Le Duc, Geza Harczi, Kader Issaley, Sani Sayadi, Nassirou Ousmane, Issoufou Yahaya, Mark Myatt, André Briend, Thierry Allafort-Duverger, Susan Shepherd, Nikki Blackwell, September 2016

3. Mother/Family MUAC Strategy in the Context of COVID-19. Northeast Nigeria Nutrition Sector, 2020.

4. Northeast Nigeria Nutrition Sector MOTHER MUAC Strategy, UNICEF 2020

?Part III

ESAR: Kenya and its current experience of the Family-MUAC approach during COVID-19 context

UNICEFEastern and Southern Africa Regional Office

ESARO - USE OF FAMILY/ MOTHER led MUAC before COVID-19

• Prior to the C-19 pandemic, several

countries supported by UNICEF were

piloting the use of family/ mother led

MUAC in nutritionally vulnerable/

food insecure areas:

• Southern Madagascar• Burundi• Somalia• Zimbabwe• Kenya (best practice to be shared today)

ESARO Contd

Somalia - pilot implemented in 2018

supported by UNICEF to increase early

identification - with MoH and 136

CSO. Challenges were noted but

overall successful and now being

scaled up across the country given the

recommendation of MUAC only in the

context of COVID-19

ESARO USE OF FAMILY/ MOTHER led MUAC in the Context of COVID-19

• Eastern and Southern Africa FSNWG – co chaired by UNICEF and WHO adapted the regional guidance from WCARO (May 12th) and specifically recommended the use of Family/ Mother led MUAC and oedema only for assessment for C-19 programming.

• Subsequently Uganda MoH has recently approved the roll out of Family/ Mother led MUAC for use in the context of COVID and five other countries are reviewing the evidence and considering its application

• However some partners continue to raise concerns of the risk of some children previously included using WHZ no longer included - notably the case for pastoralist populations in Somalia Northern Kenya Sth Sudan and Ethiopia

• Suggestions such as increasing the admission criteria to 135mm, provision of a protection ration etc are being made but no clear decisions have been taken by these partners on how to offset this risk.

• Several CO subsequently conducing analysis on what proportion of children could be affected to generate evidence to guide policy

• Regional production of MUAC tapes to commence this mouth in ESAR in several countries - already ongoing in Kenya

Family MUAC pilot in Kenya and its potential benefits in the context of Covid-19

Dr Tewoldeberhan Daniel,Nutrition Specialist, UNCIEF Kenya

Use of Family MUAC in Kenya

Family MUAC Pilot in Tana River, Kenya (April – December 2019)Establish a Community of Practice between UNICEF, ACF, CONCERN on improving facility-community linkage. Secured funding as part of OFDA

proposal

Red yellow Green

<11.5cm 28 19 (67.9%) 9 0

11.5 - 12.49 cm 83 5 77 (92.8%) 1

>12.5cm 38 5 32 1 (2.6%)

Total 149 29 118 2

Health worker's

Measurement

Mother's measurement

MUAC classification

Objectives

i) Determine effectiveness of mothers use of MUAC for screening for acute malnutrition in children under 5 years of age, ii) To identify the enablers, challenges and potential pitfalls in Mothers’ screening their children for acute malnutrition using MUAC,iii) Provide programmatic recommendations emanating from the pilot to inform national scale up of Family MUAC approach.

• A total of 6,966 mothers trained and issued with MUAC tapes • Majority of the children found to be normal and the mothers didn’t

seek services. • 170 children (2.5% of total screened) were found by the mothers to be

malnourished and were self-referred to the health facilities formanagement of malnutrition. Information collected for 149 of them

Family MUAC Pilot in Tana River, Kenya (April – December 2019)Coverage survey done at the start and at the end of the pilot

Results showed improvement in coverage but not significant.

Emergency Nutrition Response initiated following drought emergency requiring scaled up outreaches in areas where the pilot was implemented

Therefore the anticipated benefits of family MUAC were compensated by the emergency response

The coverage survey showed that the median MUAC at admission for OTP and SFP was 11.4cm and 12.2cm indicating early admission into OTP and SFP program

Single Estimate coverage (OTP) Single Estimate coverage (SFP)

Baseline 52.6% (40.1 - 65.0) 43.2% (36.6 - 49.9)

Endline 53.7% (39.1 - 67.1) 48.9% (38.5 - 59.6)

Interviews with mothersWhat worked• Most mothers measured their children once in two weeks

and were monitored by a CHV once a month.• Most mothers were happy about the pilot since they were

able to monitor the nutrition status of their children at the household rather than waiting to go to a health facility.

• Mothers who self-referred their children to the Health Facilities indicated they were happily welcomed by the health workers & MUAC measurements of their children verified and enrolled into IMAM program.

Challenges• Most mothers mentioned they were trained but

distribution of MUAC tapes delayed hence they had forgotten to take the Measurement hence refresher training provided

• Some mothers cited challenges including heavy household workload and sometimes forgot to monitor the MUAC of their children

• Long distances to health facilities led to some not to self-refer.

• Mothers can reliably measure and identify malnourished children• Family MUAC has empowered and improved motivation caretakers for care services• Outreached could have confounded the potential increase in coverage• In the context of COVID, family MUAC will likely contribute to IPC

Family MUAC in the context of Covid-19

Next Steps

Why rollout now?

Potential to safeguard the gains in IMAM by sustaining screening for acute malnutrition,

Early detection and referral for treatment at the nearest health facility,

Contribute to the achievement of the Covid-19 infection prevention and control measures.

Phased Approach of rolling out to ten counties over six months

▪ High risk counties for COVID 19

▪ High GAM prevalence and caseload

▪ Existing capacity and experience in Family MUAC

▪ Leveraging on existing/ongoing project with secured funding.

Steps for the roll out of Family MUAC

National level consensus building

Sensitization of three levels: County/ Sub-county, Facility and Community levels

Training of CHVs followed by training of mothers/caregivers

Early procurement of MUAC tapes. ▪ So far a total of 750,000 MUAC tapes procured and Distributed. A further 1 million MUAC tapes under procurement.

Family MUAC Way forward in Kenya

Q&A

Next Steps for Scaling Up

?Part IV (Annex)

Family-MUAC implementation and adaptations during COVID-19Resources

UNICEFWest and Central Africa Regional Office

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Mother-MUAC implementation: training

❖ What training for the Family-MUAC approach ?

Globally (before COVID-19), there are a variety of approaches being used in the same country by different NGO partners (see resources). Whilst one standardized approach may help coordination, a singular approach may be too restrictive given different ways of working of partners, the different community platforms that exist and the context and/or the country.Below are some global common features of implementers in the WCARO:

Who is trained?

Mother 6-59 monthsAnd sometimes soon-to-be mothers (ALIMA)And fathers/others (ACF)

Who are used as trainers ?

Mainly CHWsbut can be Health Promoters, Nutrition Assistants,and Nurses.

What is the content of the training?

Mixed: short presentations using videos/pictures/drawings (what is malnutrition) + practical session (MUAC measurement +edema)

Simple and clear words are usedThe fact that early detection can reduce the risk of death or the need for a lengthy hospital stay is highlighted and effective (ALIMA)

What is highlighted in the training?Where to train?

Cascade training is recommended From community level to health center levelBy using existing community platforms

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Mother-MUAC during COVID-19 context: adaptations

❖ What can be recommended during COVID-19?

3 INGOs (GOAL, SCI and Concern) in the region have developed and shared adaptations to the approach during COVID-19, especially in terms of trainings (see resources).As for training under “normal circumstances”, the selection of training will greatly depend on the “structural” context (existing platforms). Then, the “conjectural” context (phasing of the epidemics, lockdown, restrictions…) and the initial knowledge of the approach in the area (implemented before or not) will guide the design.

Co-design the Family-MUAC approach

Use lesson learned from existing implementation in the country (SCI)

Coordinate with all implementing partners under the guidance of MoH/Clusters

Use existing community mechanisms to integrate Family MUAC and oedema assessment training rather than creating new parallel groups specifically for this activity. (SCI)

Adapt training of mothers to context

Distribution of MUAC at the same time to avoid multiplication of meetings

Community LevelSmall groups of 10 (GOAL) Or house-to-house visitsOr SMS (if no access or as reminders)Or mixed

Health center LevelSmall groupsOr individual counselling

Adapt training of trainers to context

HH visitsSmall groups with physical distancing measures pictured on the ground.SMS (as reminders)

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RESOURCES

Family-MUAC in COVID-19 context:

▪ UNICEF-GNC-GTAM_Management of Child wasting in the context of COVID-19

▪ GOAL_Family-MUAC in the context of COVID-19_Guidance Note_ 22 April 2020

▪ Concern_Interim guidance_17 April 2020_Adapting Community-based Management of Acute Malnutrition in the context of COVID

▪ Save the Children International_Family MUAC Approach in the Time of COVID-19: Implementation guidance for programme managers

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RESOURCES

The approach▪ CORTASAM Recommandation sur l’usage du

périmètre brachial au sein de la communauté ▪ The MUAC for Mothers Approach : ALIMA▪ The Family MUAC Approach: Action Against

Hunger Senegal▪ Stratégie PB ménage dans le Département de

Linguere (Louga, Senegal)▪ The Family-MUAC approach: World Vision in

Mauritania▪ GOAL Presentation: Family MUAC approach

Case studies▪ Family MUAC: COOPI in DRC - Case Study▪ The Family-MUAC approach: GOAL

Tools▪ The Family MUAC Approach: The Click-

MUAC Project

Trainings▪ Mother-MUAC Teaching Mothers To Screen For

Malnutrition (ALIMA, training)▪ GOAL: Training guide for Family-MUAC

approach▪ World Vision: Mother-led MUAC tools

M&E tools▪ GOAL Family MUAC M&E Toolkit▪ IMC_M&E tools for the Family MUAC approach▪ CRF_M&E tools and training (contact anne-

sophie.desmaris@croix-rouge.fr)

And for more information:https://www.acutemalnutrition.org/en/Family-MUAC