Community-based management of acute malnutrition (CMAM) in India: a position paper

Meeta Mathur, Abdul Halim, Mousumi Gupta, Bijayalaxmi Panda, Arish Syed


Considering the burden of Severely Acute Malnutrition (SAM) in India and the availability of SAM treatment at facility level, it is operationally not feasible to treat all SAM children. The community- based approach involves timely detection of severe acute malnutrition in the community and the provision of treatment for those without medical complications with ready-to-use therapeutic foods or other nutrient-dense foods at home. Community based Management of Acute Malnutrition (CMAM) is an integrated approach which on one hand focuses on treatment and on the other prevention. CMAM has a key component of community mobilization which is crucial for prevention. The present paper emphasizes the position of CMAM in India in terms of preventive vs curative, integrative approach, multi sectoral engagement, mental health perspective as per the facts available through secondary sources in India and also experiences of CMAM-I phase implemented in Rajasthan. A CMAM programme can be an ideal and well established programme considering the inclusion of different aspects such as alternative feasible solution, convergent action, multi-stakeholders roles and accountabilities.


Acute Malnutrition, Community based management, Position paper

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Valid International. Indian CMAM Pilot. Available at: Accessed on 21 March 2017.

MWCD and UNICEF. Rapid survey on children, 2013-14, National report, New Delhi, 2016. Available at:

UNICEF. 2007. Nutrition Report, New Delhi. Available at: Accessed on 5 June 2018.

UNICEF. Monitoring the situation of children and women, 2016. Available at: Accessed on 10 June 2017.

IIPS and MoHFW. India Fact Sheet Data of NFHS-III (2005-06) and NFHS-IV (2015-16). Available at:

Burza S, Mahajan R, Marino E, Sunyoto T, Shandilya C, Tabrez M, Kumari K, Mathew P, Jha A, Salse N, Mishra KN. Community-based management of severe acute malnutrition in India: new evidence from Bihar. Am J Clin Nutri. 2015 Feb 25;101(4):847-59.

National Health Mission. Government of Rajasthan. POSHAN programme, 2016. Available at: Accessed on 08 August 2017.

World Vision India & Government of India. Urgent Management and Nutritional Growth (UMANG), 2016. Available at: Accessed on 17 June 2017.

Sneha. Aahar’s provision of supplemental ready-to-use foods, Vitamins and medications, processes and electronic data collections as part of a CMAM programme, 2014. Available at: Accessed on 02 June 2018.

Action Against Hunger India. Position Paper on CMAM, 2017. Available at: Accessed on 5 July 2018.

Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?. The Lancet. 2013 Aug 3;382(9890):452-77.

Black R, Alderman H, Bhutta Z, Gillespie S, Haddad L, Horton S. Executive summary of The Lancet maternal and child nutrition series. Maternal and Child Nutrition Study Group (eds), Maternal and Child Nutrition. 2013:1-2.

Khara T, Dolan C. Technical briefing paper: The relationship between wasting and stunting, policy, programming and research implications. Emergency Nutrition Network [homepage on the Internet]. 2014. c2015.

Roberfroid D, Hammami N, Lachat C, Weise Prinzo Z, Sibson V, Guesdon B, et al. Utilization of mid-upper arm circumference versus weight-for-height in nutritional rehabilitation programmes: a systematic review of evidence. 2013.