Assessment Of Programme Quality Of Community Management Of Acute Malnutrition (Cmam) In Maiha Local Government Area, Adamawa State, Nigeria

*Nwankwo, R.N1
., Chukwuemeka . E.N.2and Ahkalola , E. E 1.
1 Department of Nutrition and Dietetics, Federal Polytechnic Mubi
2 Department of Home economics, Federal College of Education Eha-mufu.

*Corresponding author: ngozinwankwo82@yahoo.com
ABSTRACT
Background: Community management of acute malnutrition (CMAM) programme was initiated to increase the
number of children to be treated of severe acute malnutrition (SAM) without being admitted to the health facility and
to reduce cost.
Objective: The study assessed the programme quality (facility quality and performance indicators) of CMAM in
Maiha Local Government Area (LGA) of Adamawa State.
Methods: The five Out-patient therapeutic (OTP) centers in Maiha LGA were assessed in the month of August, 2018.
Self- administered OTP observational checklists based on the national guidelines of CMAM evaluation checklists
were used to elicit information from the officers in – charge of each OTP center. Variables observed for facility
quality included facility layout and flow of activities, protocol adherence, reporting and documentation and Stock of
drugs / essentials. Records from CMAM registers of each center were used to evaluate their performance indicators
(admission list, cure rates, death rates, default rates and non-recovery rates). Simple percentages were used to assess
their level of performance quality which was compared with the National standards. Sphere standards of nutrition
programming were used to assess the performance indicators.
Results: Results showed that all the centers scored from 77.27 – 90.91% on facility layout and flow of activities. On
protocol adherence, all the centers scored from 41.67 – 54.17%, while reporting and documentation revealed 50 –
80% across the facilities. Stock of drugs and essentials in all the facilities recorded 33.33 – 66.67%. Overall
performance of the centers lies from 59.68 to 69.35%.There is significant difference between the performance of
Jamtari center and all other centers. Total facility scores lie between 59.58 and 69.35%. The performance indicators
revealed that admission lists of the centers were from 243 to 520 patients; cure rate of 85.50 -96 .92%; death rate of
0.19– 2.04 % and default rate of 2.69 – 4.53% across the centers.
Conclusion: Minimum sphere standards of nutrition programming were achieved in all the centers. However out of
stock of Ready to – use- therapeutic foods a core component of CMAM in some of the health facilities demands that
government should include RUTF in the essential drugs lists of the state to increase the quality of CMAM programme
in the affected communities.
Key words: CMAM, performance indicators, performance quality, Minimum sphere standards, RUTF.