Globally, approximately 50 million children at any given time suffer from acute malnutrition, including nearly 18 million children the IRC estimates living in conflict and crisis-affected contexts. A cure exists — a simple package of peanut-based paste, delivered through daily doses over a few months — but the system to deliver it is broken, making treatment inaccessible for 4 out of 5 acutely malnourished children globally.

The IRC and its partners have developed an innovative package of care that enables treatment for children in their communities, at scale, which includes:

• A simplified protocol developed in partnership with Action Against Hunger and the London School of Hygiene and Tropical Medicine that treats all acutely malnourished children with the same food product and in the same place, adjusting dosage based on severity. Under the current system, malnutrition is divided into two categories — moderate and severe acute malnutrition — with two separate treatments by two different United Nations Agencies.
• A toolkit that enables low-literacy community health workers to deliver treatment, allowing children to receive care where they are, instead of requiring travel to health facilities.
• An adapted approach that empowers families to screen children for malnutrition in the home to assess the severity of a child’s malnutrition status as early as possible, developed by the Alliance for International Medical Action (ALIMA).

Operational pilots have demonstrated the safety, feasibility and cost-effectiveness of these approaches. In Somalia and Mali, we tested the simplified protocol, and achieved a child recovery rate of 98% and 96% respectively. We also found community health worker delivery of treatment to be feasible and effective. In South Sudan, 84% of caregivers of children reported they had no other access to malnutrition treatment, suggesting that in the absence of community health workers they may not have received treatment. In addition, a randomized controlled trial in Kenya and South Sudan demonstrated the simplified protocol was as effective as the current global approach at a lower cost. The combined results from these studies show us that there’s potential to expand treatment coverage at a reduced cost over time by delivering care within communities, requiring less product with simpler guidelines

The number of malnourished children will continue to increase during the COVID-19 pandemic, contributing to current projections of an additional 6,000 child deaths every day worldwide. As health systems become strained, this approach to malnutrition treatment can empower communities to diagnose malnutrition early, minimize travel, and reduce reliance on health facilities. These approaches have been recommended by the United Nations for nutrition programs affected by COVID-19, and the IRC led the global task force to develop a toolkit; we’re now exploring co-leading this group with UNICEF going forward.

We have adapted our research plans to generate evidence from programs that are using these innovations during the pandemic, and we will be able to understand the impact of COVID-19 on nutrition programs by comparing core indicators to previous years. We will also continue to evaluate the simplified protocol for effectiveness in terms of recovery and cost-effectiveness, in different contexts and when treatment is delivered by community health workers and in combination with empowering parents to screen their own children for malnutrition.

We can create a future in which every malnourished child gets the treatment they need. Over the next five years, through IRC and partner programs, we will aim to treat nearly 3 million malnourished children with the simplified protocol delivered through community health workers. Through this work, we will generate much needed data to inform policy, allowing us to drive change on a much larger scale in how malnutrition is treated globally.

This is one of three global research and innovation priorities at the IRC. Learn more.