We work in Haiti and have currently been following the Haitian National Protocol for treatment of acute malnutrition. Our donor who had been supporting us in both RUTF and RUSF has decided to stop funding RUSF and only RUTF. I am wondering what people's experiences have been in using RUTF for children with MAM and in what quantities. Is it per weight or similar to using 1 packet a day as a supplement. If it is the latter has anyone supplemented with children's multivitamins? Also, the Haitian National Protocol uses both MUAC and WHZ as admission and discharge criteria for both OTP an SFP. I have read arguments for using one vs. the other. For children with SAM the discharge criteria for Haiti is WHZ >/= -1 and MUAC >/= 115 and then all of these children should automatically be put into SFP for 3 months. Do you suggest we treat those children with SAM until they reach WHZ >/= -1 and MUAC of >/= 125 in the OTP or once they reach discharge criteria transfer them to SFP until they reach both of the latter requirements?
Dear Taryn, I presume you have seen the post on expanded admission criteria for CMAM [url=http://www.en-net.org/question/1493.aspx]here[/url] which links to a guidance note on using RUTF for MAM treatment and RUSF for SAM in exceptional cases where the other commodity isn't available? This note was developed by a group of agencies based on their experiences and should offer you a useful starting point. The authors may also be able to provide further information to you. Best wishes, Tamsin
Tamsin Walters
Forum Moderator

Answered:

9 years ago
Dear Taryn, I am currently replacing Jeanette who supported drafting the guidance note. There is no standard answer, as options are based on the context and operational capacity. I could share some examples of how other countries/organizations have adapted their programs. Could you reach out to me so that we can discuss privately. I am reachable on stien.gijsel@rescue.org. Thanks. Stien
Stien Gijsel

Answered:

9 years ago
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