Effectiveness of decentralizing outpatient acute malnutrition treatment with community health workers and a simplified combined protocol: a cluster randomized controlled trial in emergency settings of Mali

Outpatient treatment of acute malnutrition is usually centralised in health centers and separated into different programmes according to case severity. This complicates case detection, care delivery, and supply chain management, making it difficult for families to access treatment. This cluster randomised controlled trial in Mali assessed the impact of treating severe and moderate cases in the same programme using a simplified protocol, and decentralising treatment outside health centers through community health workers (CHWs).

The study concludes implementing a simplified combined treatment programme and adding CHWs as treatment providers can improve coverage while maintaining non-inferior effectiveness, reducing the expenditure on nutritional intrants, and ensuring the continuum of care for the most vulnerable children.