This brief is produced by the Operations Research and Impact Evaluation (ORIE) project, led by Oxford Policy Management (OPM), and it summarises the learning from a Community management of acute malnutrition (CMAM) intervention implemented in northern Nigeria, with the support of the Working to Improve Nutrition in Northern Nigeria (WINNN) programme.

Key messages

• Political support for CMAM services is critical for public financing and sustainability, and can be developed through evidence-based advocacy to highlight the severity of the problem of malnutrition in northern Nigeria.
• Engaging community leaders and local organisations in CMAM oversight promoted strong local ownership and community support.
• The resources required to treat the current burden of SAM in northern Nigeria are many times higher than the amounts currently spent. Continued advocacy is needed to increase awareness among senior political leaders of the health and economic benefits of effective treatment of SAM.
• Alternative ways of treating SAM may be needed in severely under-resourced health systems, like those in northern Nigeria. These could include integration of RUTF provision with existing primary health care services, or less frequent visits to health facilities by caregivers to collect RUTF (which will be trialled in Sokoto).
• Inadequate human resources for health were a key challenge for the provision of CMAM services. CMAM services require adequate planning and allocation of human resources. The government will need to consider hiring more health workers if it is to sustain and scale up the CMAM service.

ORIE briefs are also available on the following themes:

• Governance
• Gender
• Micronutrient supplementation
• Improved infant and young child feeding (IYCF)