Prevention and treatment of moderate acute malnutrition (MAM) amongst children 6-59 months and Pregnant and Lactating Women through integrated community-based approach using Tom Brown local solution in Affected communities of Michika and Madagali LGAs of Adamawa state CDHI will implement 12-month MAM management for children 6-59 months and PLWs using locally available blended food – Tom Brown model. And promote malnutrition prevention through IYCF promotion and increased demand for consumption of nutrient dense locally available foods as well as increased access to specialized skilled IYCF counselling amongst nutritionally vulnerable groups particularly PLWs and caregivers of children 6-23 months. MAM PLWs and children 6-59 months identified using MUAC screening (MUAC lt/= 22cm in case of PLWs and MUAC lt 12.5 cm and gt 11.5 cm) in case of children will be enroll in a cohort and will receive intervention that treat MAM using local solution (Tom Brown). MAM management will include the use of Tom-brown model and with a linkage to other health and nutrition services such as MNP supplementation, routine medications as per the revised national guideline of community management of Acute Malnutrition, in collaboration with UNICEF and ADSPHCDA. 
PLWs and caregivers of children 6 -23 months, adolescent girls’ women and men will receive MIYCF promotion activities through community peer group platforms using mother or father peer support group. IYCF promotion activities through the established support groups will be facility by trained CNMs and lead mothers based in the communities. Cooking demonstration will be integrated in IYCF sessions. PLWs and caregivers of children 6-23 months will receive individual skilled IYCF counselling at the community or facility by trained CNM or CHWs respectively. Capacity of community structures will be built on malnutrition programmes to ensure that members of community take ownership and are able to respond to their nutrition needs using tested local models.
The nutrition activities will be linked with nutrition sensitive sectors WASH, Health, child protection and GVB sub-sector. CDHI will distribute soap to IYCF peer support group members to encourage practice of hand washing. Similarly, MAM PLWs will be identified through existing ANC services at health facilities. Those identified at the community level will be encouraged to access ANC services. Caregivers of children 6-23 months in the communities will be encouraged to access immunization services at the facilities. CDHI will leverage on its existing UNFPA/PPFN project on GBV prevention to ensure that GBV prevention and mitigation measures are well mainstreamed in the communication package that will be delivered to the members of the community including father peer group through the group platform. gender and accountability to affected population is well mainstreamed in the programme designed. 
A quasi-experimental longitudinal prospective cohort study will be nested within ongoing community-based MAM management local solution. The study will have two comparison groups which receive different intervention packages. All arms will have comparable health promotion and behavioural change communication (SBCC) activities.  In one study arm, beneficiaries will receive tom brown meals about 200g/p/d for eight weeks without linkage to health facility for other complementary health and nutrition services in addition to health promotion and SBCC services.  In another study arm, beneficiaries will receive tom brown meals about 200g/p/d for eight weeks with linkage to health facility for other complementary health and nutrition services (MNP and routine drugs) in addition to health promotion and SBCC services. Beneficiaries will receive interventions for a maximum of 3 months and will be followed until another 3 months post-intervention. The study will assess the effectiveness of use of tom brown in the management of MAM, implication, and cost effectiveness for linkage with health system in humanitarian setting.  Finding from the operational research will be used as an advocacy tool and by programme managers to inform future response in the spirit of scaling up localization.