For exit strategy, ensure that. Training and capacity building of DOH staff on CMAM and IYCF to transfer skills. Blanket distribution will be carried out to cater the need of in program patients and new patient will be enrolled till last working day if handed over the program to MoH/DoH or other partner. Its better to enrolled patients till last minute to provide them ration. These are what i know. Thanks

Is there sustainable mechanism developed in advance jointly with the DOH/MoH? What is the current situation of GAM and SAM in the project sites? and also the aggravating factors of the issues? Is there integration with regular government services and Government is willing to takeover the responsibilities? I think, it depends on these factors. Is there are cases, government should take the responsibilities for the management of acute malnutrition. Is there such exercise? I think, during the programme period, we should have consultation with the DoH/MoH for the sustainability of the programme integrating with different health and nutrition activities. Meeting minimum standard is one aspect, but the sustainability and CMAM programme integration with ongoing programme is the major thing for phasing out the project.

When it comes the matter of Strategy, it involved series of tasks to be done. The first thing to be considered is whether to exit or not, so per rules if there are less than 30 SAM cases Exit strategy should take place. An exit strategy involves, Capacity and needs assessment of the Govt facilities in the area, Coordination on exit strategy with the facility, community health worker supervisors, key contacts in the community and community leaders, and donors. Train the Key staff such as: The facility staff (doctors or nurses) on management of malnutrition, community health workers or supervisors on screening and referrals as well as on Nutrition promotion sessions. Document the exit strategy, facilitate the liaison of health facility with the donor (unicef and WFP) and arrange a tripartite memorandum of understanding. Developing a monitoring and supervision plan and handing over the important documents for the management of program. Handing over the the logistics required to run the program and training staff on its use. The pillar of the program are the community health workers, much focus is needed on this section of the program. Hope this helps you. Thanks.