Increase treatment by reaching 85% of children with wasting by 2025

The priority actions are multisectoral (Health, Food Systems and Social Protection) and include:

Health System

• Scale up Integrated Management of Acute Malnutrition (IMAM) services across the target counties.

• Strengthen and scale up nutrition care for wasted inpatients and clients with disease and/or comorbidities.

• Improve screening and referral for acute malnutrition at the household, community, health facilities and institutional level. Community health volunteers (CHVs) can engage through community units (such as integrated community case management (ICCM)) to empower mothers and care-givers through family mid-upper arm circumference (MUAC) measurements, growth monitoring at health facilities, early childhood development (ECD) centres and at the household level by CHVs. Strengthen nutrition screening and assessment for disease-related malnutrition in health facilities.

• Develop infrastructure and capacity of health workers and institutions for service delivery. Conduct trainings, on-the-job training, continuing medical education and mentorships, and provide technical guidelines and job aids.

• Use available mechanisms for coordination of IMAM and to link IMAM services with other programmes (water, sanitation and hygiene, livelihood, social protection and food security).

• These coordination forums include nutrition technical forums, Emergency Nutrition Advisory Committee (ENAC) and multisectoral coordination forums.

• Scale up innovative approaches for nutrition education and communication, such as Nutrition Improvement through Cash and Health Education (NICHE), adoption of rapid-pro and other social and behaviour change communication (SBCC) strategies. Strengthen Monitoring, Evaluation, Accountability, and Learning (MEAL) systems to ensure evidence-based decision-making and accountability to service users. Conduct operational research for new approaches. Adopt community initiatives to promote community empowerment for accountability, including complaints and response mechanisms, community conversations, community dialogues and actions through community units.

• Advocate for and mobilise resources and financing for nutrition service delivery, including supply chain management, and ensuring this is covered by government health insurance such as National Hospital Insurance Fund (NHIF)/Universal Health Coverage (UHC). Advocate for the inclusion of nutrition budget lines in county and national annual budgets, especially for nutrition commodities. Support the development of county strategic planning processes, including the County Integrated Development Plan (CIDP), annual workplans (AWPs), and County Nutrition Action Plan (CNAP).

Food System

• Strengthen supply chain systems for the delivery of key commodities for the management and treatment of child wasting.

• Improve reporting through online logistics management information systems, accurate projection and timely requisition of nutrition commodities.

• Strengthen mechanisms to monitor safety, quality and adherence to standards for nutrition supplies for management of wasting, including end user monitoring.

• Strengthen and scale up local production of nutrition commodities.

Social Protection

• Provide cash transfers to all households with pregnant and lactating women with children below 2 to 5 years of age and poor and vulnerable households taking care of orphans and vulnerable children (consolidated cash transfer (CCT) programme).

• Support scaling up unconditional cash/food transfers during shocks such as drought, floods and pandemics to reduce exposure to poor health and nutrition.