We did  shortening training durations while doing nutrition response during an earthquake emergency in Nepal in 2015. In the earthquake emergency, the Government had restricted to all the health workers not to leave their working area because of this, Nutrition cluster unable to gather health workers and conduct the SAM management training at district level, and then cluster decided to squeeze training package into two days and conduct training at facility level. The training schedule developed accordingly and conducted facility based training focused to the OTP center. The OTP centers were identified by the District Health and Nutrition Cluster. The two days training package focused more onto the technical aspect of wasting management; target children, MUAC and edema measurement, appetite test, identification of medical complications, ration calculation, follow up visit, referral criteria and mechanism, discharge criteria, recording and reporting. In fact, Nepal has 4 days standard training package for the management of SAM (out-patient).  

What went well:

• 4 to 5 health workers were trained at each health facility which was easy to guide.
• Close monitoring, observation to practical sessions
• All health workers were trained at once
• Little preparation worked for training
• Established OTP sites during the training period

Challenges

• WFH indicator was not included due to which, the larger number of potentially high risk children might not be captured.
• Community outreach component was excluded.
• It was facility based training therefore; sometime high patient follows disturbed training.