Report Summaries

Scaling up severe wasting programming
This is a summary of the following paper: Action Against Hunger, International Rescue Committee,
Save the Children UK, and UNICEF (2023) Scaling up coverage, quality and sustainability of early
detection and treatment of severe wasting programming for children.
https://www.nutritioncluster.net/resources/delivery-systems-scaleChild wasting, a preventable condition, critically impacts children'sability to survive and thrive. Whileevidence-based approaches to treat
severe wasting exist, the challenge lies in effectively providing these services to the most atrisk children. The 'Delivery Systems for Scale'project (December 2022 to September 2023)
was developed by International Rescue Committee, Action Against Hunger, and Save theChildren, in partnership with USAID and withsupport from UNICEF. The project focused on
three core areas: Country-driven support, coordination and learning, and technical and coordination support.

global targets. Country-level scaling action
was supported through various global and regional activities to address barriers.

A project learning component reviewed
global progress scaling up coverage, quality, and access to detection and treatment programmes for children with severe wasting from2013 to July 2023, building on a 2013 global
stocktake by Action Against Hunger and theCoverage Monitoring Network (ACF, 2013).

Despite this progress, the report showedthat challenges persist. Health system fragility, inadequate human resources, limited political will, and insufficient funding continue
to hinder scaling efforts. Collaboration between health and nutrition sectors, as well asengagement with the private health sector, remains critical. Fragmented knowledge management also poses barriers. Improvements in datacollection, analysis, and use have been made,but gaps in data proficiency and accountability persist. The expansion of financing instruments requires better coordination and tracking to optimise resources effectively. Significant
advancements in materials and supplies, particularly with Ready-to-Use Therapeutic Food,highlight the need for optimisation of national supply chains.

Moving forward, a child-centred systems
approach is recommended to integrate prevention, early detection, and treatment ofchild wasting. There are five key recommendations from this analysis which can be taken forward. First, to define and implement
methods to integrate routine detection andtreatment of child wasting within national
health systems. Second, to strengthen knowledge management by investing in retrospective and prospective learning and commit
to simplicity and clarity in communication.
Third, review and update success metrics, including targets, monitoring, and accountability frameworks, aligning them with national
government priorities. Fourth, leverage the2023 WHO Guideline and the 2020 UN Global Action Plan for Wasting rollout, along withmomentum on universal healthcare, to address governance, prioritisation, and resourcing gaps with national actors. Fifth, defineand strengthen collaboration with the private
sector within frameworks that support childhealth and nutrition.

References
ACF (2013) A decade of community-based SAM management 2013. https://www.ennonline.net/ourwork/
othermeetings/communitybasedsam2013© UNICEF/UN022131

Over the past decade, significant progresshas been made through collective efforts bynational governments, NGOs, UN agencies,
civil society, and donors. Increased financing
resulted from joint advocacy and donor engagement, leading to incremental integration
into national systems through expanded policies and resources. Developments in information systems laid the foundation for systematic adoption and tracking of national andKey enablers for this progress included sustained advocacy, predictable technical support, and coordinated research agendas. Country-level technical working groups played acrucial role in mobilising action and addressing
technical and operational shortfalls. The launchof the UN Global Action Plan for Wasting in2020 and the 2023 WHO Guideline for the prevention and management of acute malnutrition
present new opportunities to accelerate prevention and treatment efforts.

FIELD EXCHANGE ISSUE 73, July 2024 www.ennonline.net/fex

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