Until recently treatment of severe acute malnutrition (SAM) has been restricted to facility-based approaches, greatly limiting its coverage and impact.  Recent evidence (Emergency Nutrition Network, 2011) suggests that large numbers of children with SAM can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre.

CMAM involves timely detection of SAM in the community and provision of treatment for those without medical complications with RUTF or other nutrient-dense foods at home. If properly combined with a facility-based approach for those malnourished children with medical complications and implemented on a large scale, CMAM for SAM could prevent many deaths of children.

Generally there are not, as yet, widespread CMAM interventions in Nigeria, although UNICEF, SCF and ACF International are in the process of implementing such approaches. The section on Nigerian Experiences describes the efforts to assess and implement the effectiveness of CMAM interventions in the North; there have not yet been any evaluations of effectiveness. Distance to community centre can still be important for many rural households. But rural communities in the NW states have a strong social cohesion and willingness to ensure that malnourished children receive care.