In 2018, 49.5 million children were affected by wasting (7.3% of children around the world). Despite significant progress in treatment coverage and preventative efforts in the past decade, many children are left untreated and wasting is still one of the largest drivers of mortality for children under 5, responsible for up to 2 million deaths annually. Much more action is needed to achieve the World Health Assembly target for wasting by 2025: to reduce and maintain childhood wasting to less than 5%.
Historically, wasting treatment was delivered as an emergency program with limited scale and sustainability. Since 2007, there has been a focus on the integration of wasting treatment into health systems in order to scale-up and strengthen programming. While there has been an evolution of knowledge on integration, generated based on experience and emerging evidence, there are still key questions faced by country program planners: what does integration look like in my context, what are the potential benefits and challenges, and how to action?
In 2020, UN Agencies released a high-level Global Action Plan for wasting (GAP) that outlines priority actions to achieve the Sustainable Development Goals (SDGs) for prevention and treatment of wasting, through a systems-wide approach. A key outcome of the GAP is to improve treatment of children with wasting through strengthening health systems and integration of treatment into routine primary healthcare. A number of operational questions are raised on how to achieve this goal, including in the context of development of the GAP operational plan.
In partnership with UNICEF, R4D aims to assess the country and regional needs for technical support on integration into routine health systems to help strengthen and scale-up wasting programming. Our work will generate practical research and guidance to inform country-led strategies for integration of wasting treatment in health systems.
In a second component of this program, R4D is holistically assessing market barriers that are limiting the availability and affordability of ready to use therapeutic foods, and scoping opportunities to address them, with a broader goal of informing the development of global and country level strategies to optimize the market and increase access to RUTFs for wasted children.
Photo credit: Valerie Caldas, USAID Suaahara project