ACF: Integrated approach to address malnutrition through improved nutrition, health, mental health and care practices, Rakhine State

In Rakhine State, the protracted humanitarian crisis has been continuously deteriorating. The Muslim communities are largely dependent on humanitarian aid, due to restrictions of movement and limited access to livelihoods opportunities. Lack of basic health care and limited access to life-saving hospital referrals is a direct threat to the lives of women and infants. In Maungdaw District (which includes both Maungdaw township and Buthidaung township), the 2015 SMART survey shows that the nutritional situation remains dire with global acute malnutrition, chronic malnutrition and underweight prevalence above the WHO emergency thresholds. In addition, the devastating floods of July/August 2015 strongly increased the number of SAM children.

To contribute to the reduction of malnutrition, mortality and morbidity rates among children and Pregnant and Lactating women in Maungdaw District (Maungdaw and Buthidaung townships), Rakhine State, Myanmar.

• Children under 12 and PLW make up the major part of direct beneficiaries as they are the most affected by under-nutrition.

• With regard to Mental Health and Care Practices (MHCP) activities, the ACF team integrated in nutrition centres will identify the most vulnerable beneficiaries according to psycho-social distress criteria.

• 350 Super Community Care Takers (SCCTs) who have already been identified during the previous phase, through different criteria, from their motivation to the quality of their referrals and participation in ACF activities;

• 250 Traditional Birth Attendants (TBA)/ Traditional Healers (TH) will be selected by community leaders;

• 65 MoH staff will be identified by the Township Medical Officers.

1. Treatment of acute malnutrition is accessible and adequate for the beneficiaries in Maungdaw District.
2. The Ministry of Health and the community are supported to incorporate nutrition specific intervention in their healthcare activities in Maungdaw District.

Erwartete Resultate:  

• 2 stabilization centers (SC), 9 out-patient therapeutic  programmes (OTP) and 9 supplementary feeding programmes (SFP) with 13 distribution points are running;
• Passive screening in OTPs and SFPs;
• Active screening within the communities;
• Psychological support  and care practices activities are provided to most vulnerable clients;
• 1 survey (SQUEAC) and workshops are carried out to evaluate the percentage of victims of acute malnutrition in the area of interventions that are treated within ACF facilities;
• Training and refresher sessions are organized for the community members and the Ministry of Health (MoH) staff on malnutrition screening;
• Community awareness sessions are conducted to enhance the sense of responsibility of the community.

Resultate von früheren Phasen:  

ACF started its nutrition activities in 2003 and has been receiving support from SDC since 2015. During that year, 13,960 SAM children were admitted into the ACF therapeutic feeding programme while 4,092 PLW were admitted into the supplementary feeding programme (reaching 106% of the initial target value). In total, 65 staff from the MoH rural health center in Maungdaw town were trained on understanding malnutrition and screening.

Lessons learned are mainly linked to the management of the significant increase of beneficiaries, community awareness and mobilisation, breastfeeding substitute tech-niques, involvement of local doctors, number and quality of referrals by the MoH to ACF facilities and the follow up by ACF of referral cases to hospitals.

ECHO, SIDA, DFID, WFP

ACF actively coordinates its intervention with other INGOs (MSF, Malteser), UN agencies (UNICEF, WFP, UNHCR) and the authorities in Rakhine State (Township Administrators and Medical Officers)

Phase 2 01.04.2016 - 28.02.2017   (Completed)