Severe acute malnutrition (SAM) is a medical condition that weakens the immune system and reduces the ability to fight off infection. That is why severely malnourished children have a much higher chance of dying from common childhood illnesses such as respiratory infections or diarrhoea. India has the largest burden of severe malnutrition in the world, with 93 lakh children under the age of five affected by SAM.


MSF believes the treatment of SAM requires a decentralised, community-based approach to ensure greater treatment coverage and reduce the risk of patients defaulting on treatment. From 2009-2015, MSF treated over 17,000 children in Bihar’s Darbhanga district with the community management of acute malnutrition (CMAM) model. Based on the learnings from the Darbhanga project, in June 2017, MSF launched a programme in collaboration with the Ministry of Health and State Nutrition Mission in Jharkhand’s Chakradharpur block to identify and treat children with SAM using the CMAM model.

IN 2017

MSF organised participatory trainings for sahiyas (village level health workers) in Chakradharpur block, with a focus on understanding malnutrition and the community management of acute malnutrition model. During these sessions, the sahiyas explored and analysed some of the social and cultural practices leading to malnutrition.

MSF joined the frontline workers of the Integrated Child Development Services (ICDS) in observing World Breastfeeding Week from 1-7 September 2017. MSF participated in a rally with ICDS staff, and addressed various myths associated with breastfeeding and encouraged the consumption of local foods and diets in a workshop for sevikas (anganwadi workers).

MSF organised a media training workshop in Ranchi which focused on malnutrition as a social and medical problem in India and MSF’s community-based approach to treating SAM.


SAM children treated through the CMAM approach


Children screened for SAM


SAM children admitted to inpatient facility