The CMAM Surge Approach

18 December 2020

The CMAM Surge Approach has been developed by Concern Worldwide to help health systems more effectively deliver services for children with acute malnutrition.

This health centre in Tahoua, Niger, which serves over 50 rural villages, has been using the CMAM Surge approach since 2016 to help respond to increases in their malnutrition caseloads. Photo: Darren Vaughan / Concern Worldwide.
This health centre in Tahoua, Niger, which serves over 50 rural villages, has been using the CMAM Surge approach since 2016 to help respond to increases in their malnutrition caseloads. Photo: Darren Vaughan / Concern Worldwide.

Community-based Management of Acute Malnutrition (CMAM) seeks to reach as many children as possible through the provision of treatment services at decentralized care sites. However, rates of acute malnutrition remain unacceptably high. To help health systems more effectively deliver services for children with acute malnutrition, Concern developed the CMAM Surge approach. The approach is based on the observation that in many contexts the number of children seeking treatment for acute malnutrition tends to peak during certain months of the year.

 

These seasonal ‘surges’ in demand are driven by many overlapping factors, including, for example, the pre-harvest hunger gap, increased incidence of malaria or diarrhoea during the rainy season, women’s workload patterns, and movements associated with grazing livestock. It is during these caseload surges that the potential to save lives is greatest, yet government health systems and the wider humanitarian sector are often not able to provide timely, effective response. The CMAM Surge approach complements routine CMAM services by improving health staffs’ use of facility data and knowledge of the local context to better anticipate, plan for, respond to, and bounce back from these increases in demand for acute malnutrition treatment services.

 

Concern has introduced and supported implementation of the CMAM Surge approach in more than six country programs - including an adaptation of the approach focused on the treatment of malaria in Sierra Leone – and scale up continues. Concern chairs the Global CMAM Surge Technical Working Group and is an active member of the West Africa Region CMAM Surge Taskforce. The success of the CMAM Surge approach is evident by its expansion across Africa and beyond. The approach continues to innovate and expand with some programmes trialling the use of CMAM Surge data to improve community engagement, and various countries beginning to pilot a more holistic Child Health Surge.

Core knowledge products

The CMAM Surge Approach outlines a process and set of practical tools to help health facility and health district teams determine when seasonal caseload surges are likely to occur and to better prepare for and manage services during those periods of high demand. To support uptake of the CMAM Surge approach, Concern has developed global guidance documents which can be used as is or adapted to the local context. The core knowledge products are available for download below.

Additional resources

Concern has developed additional resources that peers might find useful. These resources are available for download below. 

Download
Download

Evaluations of the CMAM Surge approach

Concern has supported several learning reviews and evaluations of the CMAM Surge approach in order to inform adaptations of the approach as well as investment in scale-up. 

Global CMAM Surge Technical Working Group

The purpose of the Global CMAM Surge Technical Working Group is to ensure coordination of CMAM Surge activities to maximise quality, effectiveness, and learning. Given the rapid scale up of the approach across increasingly diverse contexts, there is a need to ensure that technical integrity is maintained and that learning is captured and used to further strengthen and refine the approach, as well as inform the development and implementation of a more holistic Health Surge. The membership includes a diverse group of CMAM/Health Surge stakeholders including Ministry of Health representatives, donors, and NGOs. The group is chaired by Concern’s Global CMAM Surge Adviser.

 

The Global CMAM Surge Technical Working Group will focus on a few key objectives:

  1. Develop and monitor a CMAM/Health Surge learning agenda
  2. Identify and promote best practice on CMAM/Health Surge
  3. Identify opportunities for, and support advocacy for, the continued scale-up of the approach

 

The operational documents of the Technical Working Group include a Terms of Reference, a workplan, and a learning agenda. While options for a CMAM/Health Surge website are being explored which will host the Technical Working Group’s documents, as well as a set of curated resources, the documents of the Technical Working Group will be available below as they are finalised.

Global CMAM Surge Technical Working Group Terms of Reference

Download
Share your concern