Integrated Research on Acute Malnutrition in Chad

Behavior change communication on Nutrition, Health \& Hygiene, including (but not limited to) awareness of dietary diversification from 6 months of age and adequate complementary feeding; and raising awareness of good water and hygiene practices.

Monthly delivery of a nutritional supplement: enriched flour (CSB++), at a dose of 3 kg/month/beneficiary child. The nutritional supplement is limited to \[6-11\] months old children diagnosed as non-wasted (green MUAC); or children \[12-59\] months old for 6 months after discharge from a CMAM treatment or consolidation program.

Delivery of micronutrient powders to \[12-23\] months old children (30 sachets per month for 2 months, every 6 months, according to international recommendations).

Monthly delivery of a water purification input: bleach or flocculant/decontamination sachets for the potabilization of the water of the whole household. The water treatment input is limited to households with \[6-11\] months old children, or children \[12-59\] months old enrolled in a CMAM treatment program and for 6 months after discharge.

"One-time delivery of a mid-upper arm circumference (MUAC) measuring tape and training of families in its use, and actions to be taken based on the results. This will involve distributing Shakir bands to all households with \[6-59\] months old children and training mothers/guardians, or any other family members who express an interest, in screening for wasting using the MUAC criteria, and explaining the procedure to follow if the child tests positive in the family.~Formative supervision of MUAC measurement in families. The training will be carried out by the members of the care groups and at each home visit, they will be able to ensure that the MUAC measurement technique is well mastered by the mother (or another member) and correct the technique if necessary."

"Monthly screening by the care group volunteers of the children they follow, using the MUAC.~Referral to the health center of \[6-59\] months old children screened as malnourished (result of MUAC orange or red), and follow-up on referral to confirm child was enrolled"

"Weekly follow-up of \[6-59\] months old children under treatment and for 6 months after discharge from the national treatment and consolidation program : care group volunteers follow children under treatment until they recover and for the whole duration of their consolidation (for children cured of severe emaciation) through weekly home visits.~They monitor treatment adherence (i.e., families follow the planned schedule of visits and receive inputs for treatment or consolidation) and treatment compliance (i.e., the malnourished or consolidating child receives the planned dose of therapeutic or supplementary food each day)."