Strengthening Integrated Management of Acute Malnutrition: Enhancing Capacity of
Health Care Workforce and Systems on IMAM in Kwale County
Authors:   Nutrition Officer | USAID
            Stawisha Pwani Amref Health Africa in Kenya, Wilson Airport, Lang'ata Road P.O.Box
            30125-00100, Nairobi, Kenya, Swa, Annette ,   RMNCAH & Nutrition
            Technical Advisor | USAID Stawisha Pwani Amref Health Africa in Kenya, Wilson Airport,
            Lang'ata Road P.O.Box 30125-00100, Nairobi, Kenya, Mwangi Faith ,   AMREF Health Africa(USAID
            Stawisha Pwani, Jumwa Rachel , Nanga Francis , Oruko Happiness , Kutna John , Masauloi Dr.Philip , Muthegi Jane 
Published: September 2024

Kwale County, comprising five sub-counties faces significant challenges related to
acute malnutrition, with notable rates of stunting, underweight, and wasting. According
to the Long Rain Assessment 2022, integrated Phase Classification acute malnutrition was
classified in the Alert Phase (IPC Phase 2) in both livelihood zones. In 2022, County
Stunting levels dropped from 34.2% reported in 2012 to 29.5% reported in 2022 which
remains at a high prevalence level compared to the national level where 22.7% of
children under-5 are stunted (KDHS, 2022). Therefore, integrated management of acute
malnutrition (IMAM) services is crucial in addressing malnutrition, with 137 health
facilities implementing these services alongside other nutrition interventions. However,
the effectiveness of these interventions depends on the capacity of healthcare workers.
Thus, through the USAID Stawisha Pwani Project, which supported capacity building for
180 healthcare workers for effective nutrition assessment and management. The overall
objective was to equip the healthcare workers with the necessary capacity to manage
early detection and treatment of acute malnutrition, prevent malnutrition through public
health interventions and education, use appropriate measurements for identification and
referral of malnourished children, and strengthen referral pathways for IMAM programs.
The methodology involved conducting training sessions for healthcare workers focusing on
IMAM principles and emerging evidence on the management of at-risk mothers and infants
under six months of age. The Results reveal that an improved screening and early
identification of acute malnutrition cases, with more children enrolled in the IMAM
program. Non-cured children in outpatient therapeutic programs also showed a downward
trend, suggesting improved quality of care. In conclusion, sustaining efforts to address
acute malnutrition requires ongoing training, mentorship and on-the-job support for
healthcare workers. This approach not only enhances retention of skills but also expands
the pool of trained staff, thereby improving health outcomes for mothers and children.
Such strategies are vital for achieving sustainable development goals and realizing
national objectives for health and nutrition and therefore continued investment in
training and support programs is essential for reducing malnutrition and promoting the
well-being of communities in Kwale County and beyond. Keywords; Malnutrition, Integrated
Management of Acute Malnutrition, Long Rain Assessment