Efforts to prevent and treat child wasting have accelerated over the last 20 years but there are still 45 million children worldwide who are wasted, or have low weight-for-height. With 45% of child deaths linked to malnutrition and only 1 in 3 children who need treatment receiving it, wasting remains a massive public health problem. 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 translate knowledge 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 2021, Results for Development and UNICEF jointly produced an easy-to-follow, 6-step process guide called Integrating Early Detection and Treatment of Child Wasting into Routine Primary Health Care Services: A Resource Guide to Support National Planning. The guide was developed through a highly collaborative process involving consultations with nutrition and health experts at the global, regional and country levels, including government representatives from five countries (Ethiopia, Kenya, Malawi, Pakistan, and the Philippines), local and regional NGO representatives, donors, and independent experts in nutrition and health systems strengthening.
UNICEF and R4D are now supporting the Federal Ministry of Health in Ethiopia (FMOH) to facilitate the development of a multi-stakeholder, national wasting integration plan using the process established in the global guide. As part of this work, the Director of Maternal and Child Health at the Ethiopian Federal Ministry of Health established a technical working group, which is chaired by the Nutrition Team at the Ministry of Health and includes representatives from the Ministry, UNICEF, WHO, WFP, international NGOs, and other development partners. Results for Development serves as a secretary and provides technical support to the working group.
Photo credit: Valerie Caldas, USAID Suaahara project