How to Strengthen the CMAM programme in Northern Nigeria and reduce rates of programme defaulting

This report presents findings from the operations research (OR) study which was conducted to identify barriers to attendance of the Maternal Neonatal and Child Health Weeks programme (MNCHW), in two states of northern Nigeria – Jigawa and Zamfara States. The work was a collaborative project between the London School of Hygiene & Tropical Medicine, Food Basket Foundation International and Oxford Policy Management. The treatment and prevention of severe acute malnutrition via the Community Management of Acute Malnutrition programme (CMAM) is one of four outputs of the DFID-funded development project “Working to Improve Nutrition in Northern Nigeria” (WINNN). This output aims to deliver, in the five WINNN supported northern states, effective treatment for severe acute malnutrition through local health systems. WINNN is implemented by UNICEF, Action Against Hunger (ACF) and Save the Children International (SCI), in partnership with the five state governments. SCI is responsible for its implementation in Zamfara, Kebbi and Katsina states, and ACF is responsible for its implementation in Jigawa and Yobe states. The CMAM services include: (1) Community outreach, for the early identification and referral of severe acute malnutrition (SAM) and later follow-up; (2) Outpatient care for children with SAM without medical complications at health facilities and at home (Outpatient Therapeutic Programme, OTP); (3) Inpatient care for children with SAM, and medical complications or no appetite (Inpatient Therapeutic Programme, ITP).