Dear Sir,

Hope this email find you well. It's an exciting project you are building. This practice beyond best practices is unfortunately common.Roughly, what came out the box, to explain it, could be resume in: local network of illegal supply, misuse of RUTF due to beneficiaries persons in charge, needs expression from adults (Malnourished or not ?).

How do you answer at Project level? 

- Social and Behavior Change Communication,

- Implement a better management of  RUTF dedicated to each development/emergency       project.

Best wishes 

Hello everybody

Consumption of RUTF by people who are not acutely malnourished is a common practice even here in Mauritania. I have often heard that some people use them as chocolate for breakfast.

So the sick are not often the only beneficiaries of the ration which is in certain circumstances shared between the other brothers and sisters.

There are studies conducted on this abuse of RUTF by
non-malnourished people. It should be noted that the community workers do not strengthen awareness and follow-up in the
community but also healthcare providers are not involved.
The only thing to reinforce is the home follow-up of all
patients on the program.
Dr John NTABO SHEBENI

Please share what might be disadvantages of RUTF eating in non-malnourished children?

Hi everyone, 

I am always uncomfortable with the direction this question usually takes. Michelo Lecharité of MSF France quite excellently denounced the tendancy for a demonisation of mothers. 

https://msf-crash.org/fr/blog/acteurs-et-pratiques-humanitaires/plumpynut-qui-profite-le-matraquage-des-meres

ALIMA also conucted a small qualitative surevy during our OptiMA DRC trial showing that mothers go to incredible lengths to make sure the RUTF goes to the intended child, often relying on older girls in the household for help in this regard. 

Hello everyone, 

In Nepal, we also experienced the same problem years ago in a few districts while working on managing acute malnutrition. 

However the technique we used to avoid this was different. 

Health workers were asked to counsel the mothers to feed RUTF as medicine. This created an assumption among mothers that medicines shouldn't be provided to every child and this prevented the misuse of RUTF in our working area, 

We also limited the supply of RUTF in the treatment centers and supplied only the required quantity as per the cases. We had nutrition officers in the field who would track the stocks and report on a weekly basis. 

Dear Kalonji,

That  is common in many countries; therefore conducting a study is something commendable. Though I am not in DRC presently, I know the situation in that country, particularly in Kasai province. I am from Kasai Region. What the government shoud do is to improve the social conditions of the population  through  provision of  social services and livelihood interventions. People are chewing RUTF and RTSF because they are starving and they are poor.  They are selling those items because they need money for nshima, food and soap. As you can see, the government should do alot for  the great Kasai Region. The level of poverty is too high. Good luck in your reseach. 

Dr Henry Ilunga Kasongo Kelakazola