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Table 3 Country experiences of successful CMAM programs nationally [31, 37]

From: Challenges and opportunities of integration of community based Management of Acute Malnutrition into the government health system in Bangladesh: a qualitative study

Indicators Ethiopia Kenya Malawi Nepal Pakistan Bangladesh
Health system characteristics
 Adequate health budget > 75% donor support > 80% donor support > 90% donor support > 50% donor support Human resources and infrastructure supported by government Overall budgetary allocation for nutrition is poor
 Availability of community based front line workers Good Good Weak Weak Good Inadequate; not utilized for CMAM
 Nutrition indicators in health MIS No Yes Yes No Yes Yes
 Supply of RUTF, F-75, F-100 Weak national supply chain F-75, F-100 supply good. Interrupted supply of RUTF Good. Local production of RUTF Good Interrupted supply of RUTF at times Sensitivity around RUTF, interrupted supply of F-75, F-100
 CMAM services integrated with other health services *IMNCI, **ICCM, immunization aIMCI, bIYCF HIV/AIDS IMCI, IYCF Unclear IMCI
Intervention components
 Active screening by government staff Good Good Good Good Yes Weak
 Inpatient care by WHO protocol Yes Yes Yes Yes Yes Yes
 Community mobilization Good Good Good Good Good Weak
 Management of MAM Weak > 80% recovery rate 89% recovery rate Weak > 90% recovery rate No services until now
Program outcomes (outpatient)
 Recovery (SPHERE standard, > 75%) 83.0% 80.7% 91% 86.1% 91.5% No national program
 Default (SPHERE standard, < 15%) 5.0% 12.9% 6.0% 9.0% 7.5% No national program
 Mortality (SPHERE standard, < 10%) 0.6% 1.5% 1.0% 0.7% 0.2% No national program
Broad Context
 National policy support Yes Yes Yes Yes Yes Yes
 National guideline on CMAM Yes Yes Yes Yes Yes Yes
 Donor supporting CMAM Yes Yes Yes Yes Yes Yes
 NGOs implementing CMAM Yes Yes Yes Yes Yes Yes
  1. *IMNCI Integrated management of neonatal &childhood illnesses, **ICCM integrated community case management, aIMCI Integrated management of childhood illness, bIYCF Infant and young child feeding
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