For the past 12 months Valid International working together with our sister charity Valid Nutrition has been supporting the Indian Government to set up and implement an operational community-based pilot to treat cases of Severe Acute Malnutrition (SAM) in Khandamal district in Odisha.  The pilot is treating cases of SAM exclusively in the community as opposed to usual practice across the rest of India of admitting such children into inpatient hospital-based rehabilitation units.   The pilot consists of three arms treating children with SAM identified through the governments community-level child development centres.  One arm provides Hot Cooked meals on a daily basis, the second an energy enriched dry Take Home Ration on a weekly basis and the third Energy Dense Nutrient Rich Food (a ready to use therapeutic food) meeting the WHO specifications).

November saw the start of this ground-breaking pilot, and for the first time an Indian government programme officially used ready to use therapeutic food delivered as part of routine programming through existing government child development services.  This represents a really important step that has huge potential ramifications for the 8 million children with Severe Acute Malnutrition across India.   Since 2008, following a controversy over the unsanctioned use of imported Nutriset ready to use therapeutic food by several international organisations, the use of these products has effectively been banned.   This had meant that India, home to almost half of the world’s cases of Severe Acute Malnutrition, remains the only major country not to use the community-based model developed by Valid International.  CMAM approach.

The pilot is funded by DFID India, is taking place in Khandamal district with a population of approximately 1 million people.  The highly developed child development services in the district has meant that the VALID team has had to support and train over 2,000 community-level workers to diagnose SAM, provide basic medical screening and prescribe the correct dose of ready to use therapeutic food to any children found to be suffering from SAM.  From the start we have worked through the government, helping them to develop their own protocols and guidelines, training and facilitating implementation and ensuring that this is a government owned and run project.  We have also facilitated the set up of a small RUTF production facility run by a local women’s self help group.  This small plant has the capacity to supply energy dense nutrient rich food to the whole district.

We are currently collecting data on the implementation and effectiveness of the pilot in order to provide the government with concrete answers as to the effectiveness of the different approaches in the India context. 

If as we expect based on our experiences in more than 60 other countries worldwide, the data demonstrates that the CMAM model using ready to use therapeutic foods is the most effective of the three approaches, the potential for this project to scale up is absolutely huge.  India has a vast network of community-based child development services with hundreds of thousands of similar centres spread across the whole country.  These centres reach up to 8 million children with Severe Acute Malnutrition, who could for the first time be offered effective treatment within a few years.