Dear Anony 2785,
Thank you for sharing your concern;
CMAM is a community based approach to manage both SAM and MAM cases through community and facility based services; it has 4 major components: community outreach, Outpatient Therapeutic Program (OTP), In-patient Therapeutic unit (TFU) and Targeted Supplementary Feeding Program (TSFP).
Dear Anonym 2785, its up to the professionals whether to develop separate guidelines for each components or not but if I share you the experience of Ethiopia, development of guideline primarily accounts service delivery points and understanding level of service providers. For example, for OTP, we have a mini reference book (quick reference) for Health extension workers, which was prepared in a simple and understandable way; likewise, we have a comprehensive guideline which encompasses all the components, and usually referred by Nutrition focal Nurses at the HC and Hospital level ;
Personally, I prefer including all components in one guideline as they all are interlinked, and helps to easily access, especially while managing transferred cases. This also works for MAM cases (under five +PLW) in TSFP.
Finally, I kindly suggest you to refer the Ethiopian SAM management protocol 2007 and 2013 edition for further information.

Thanks
Feleke M

I feel we have to define CMAM for what it is rather than for what we would like it to be.

I tend to use the term "CMAM" to mean OTP with (if possible) inpatient stabilisation. This is because of the CTC heritage. A name change (i.e. "CTC" becomes "CMAM") was required because a number of NGOs and experts were very strongly and very publicly opposed to the CTC model of care for SAM cases. The name was changed to allow these people to adopt CTC and save face.

Some people like to include a lot more that OTP/SC in CMAM ... TSFP, FBPM, &c. The problem with this is that SAM and MAM programs are rarely integrated. They tend to be managed by different UNOs, NGOs, and government departments and to be delivered in different locations. Interface issues abound. It is not uncommon (e.g.) for previously SAM kids to get lost in the system when transferred to SFP or for MAM kids in SFP to become SAM but not be referred to OTP. In many settings the TSFP, FBPM, and other components are absent or patchily implemented. In Sudan (e.g.) OTP/SC is a national program but TSFP and FPBM are implemented in only a handful of states. In this setting CMAM really means OTP/SC.

I think that (e.g.) TSFP can only be considered to be part of a CMAM program if they are tightly integrated with OTP services.

I am in favour of the wider "integrated program" or "one program" CMAM treating both MAM and SAM and closely linked with program such as GMP for case-finding but I think this is seldom achieved.

The READY Initiative and the IFE Core Group are excited to launch the Infant and Young Child Feeding in Emergencies (IYCF-E) during Infectious Disease Outbreaks eLearning course. This free, one-hour course is designed for health and nutrition technical advisors, program managers, and clinical managers working in humanitarian settings. It aims to equip learners with knowledge on key actions to take prior to and during an outbreak to protect, promote, and support recommended infant and young child feeding practices.

This course, along with the READY eLearning course, IYCF Remote Counseling: How to support caregivers during infectious disease outbreaks and other settings, and many others can be found on the READY Outbreak Readiness and Response Hub on Kaya. 

The Government of South Sudan has IMSAM guidelines in place which can be downloaded here. These are integrated guidelines which include all of the components of CMAM from 2009
[https://www.humanitarianresponse.info/en/operations/south-sudan/document/goss-moh-imsam-guidelinesnov15-word-2009-version]

The Nutrition cluster has a resource site for nutrition related documents;
[https://sites.google.com/site/nutritionclustersouthsudan/documents-1/guidelines]

You may also be interested in this document discussing the integration of CMAM programming in South Sudan,
[http://www.malariaconsortium.org/media-downloads/248/]