MANGO: Modelling an Alternative Nutrition protocol Generalizable for Outpatient

What humanitarian need is being addressed?

Since the innovation of RUTF and its scale up in the community based management of acute malnutrition (CMAM), the dosage for treating children with SAM has not been revised despite the perception of scientists and practitioners that children under the current treatment are not reaching the expected weight gain. There is a gap in evidence describing how the current dosage corresponds to the nutritional requirements and the response to treatment of a child with SAM.

What is the innovative solution?

At the invention stage of the innovation, ACF will develop a dosage table which corresponds to the response to treatment in children with SAM and is adapted to their requirements. Since the establishment of RUTF, the dosage for SAM has not been revised and through this product innovation, ACF will contribute to the establishment of an optimized dosage of the existing Product i.e. Ready-to-Use Therapeutic Food (RUTF) for uncomplicated SAM.

How does the innovation build on and improve existing humanitarian practice?

Children with uncomplicated Severe Acute Malnutrition (SAM) are treated with a fixed amount of RUTF per body weight. By following the current protocol of dose by gain of weight, the amount of RUTF to provide increases according to the progressive weight gain until discharge from the programme. However, the dosage of RUTF for SAM treatment has not been reviewed since its establishment and experts nutritionist hypothesize that the energy requirements change throughout treatment and hence that energy intake should be adapted accordingly. Moreover, practitioners perceive that not only children may need less RUTF to recover, but that an optimized dose may reduce the proportion of selling and sharing of the product.

WHAT ARE THE EXPECTED OUTCOMES?

An optimized RUTF dosage table will be established through this project which takes into account the response to treatment of children recovering from SAM. At the implementation stage of the innovation, this dosage table will be piloted in the field through a randomized controlled trial to ensure robust evidence can be collected and used afterwards to justify the scale up of an optimised dosage in CMAM programs.