MSF Pilot Project

In 2005, a year of exceptional food insecurity in Niger, MSF treated more than 60,000 severely malnourished children using therapeutic ready-to-use food (RUF).

To read full article published in Field Exchange

38,000 severely malnourished children were treated in Maradi alone with a cure rate above 90%. This experience suggested to MSF that the vast majority of severely wasted children could be cured with ready-to-use therapeutic food.

Given the excellent results for treating children with severe acute malnutrition, in 2006 MSF extended the use of therapeutic RUF through an outpatient strategy to moderately malnourished children.

To read full article published in Field Exchange

© Anne Yzebe

Nearly 65,000 children were treated (including children with moderate malnutrition and severe malnutrition). Recovery rates reached 95.5% among the moderately malnourished and 81.3% among the severely malnourished. Most notable however was that the seasonal peak of admissions of severe malnutrition cases that have occurred every year since 2001 when the programme opened in Maradi did not occur this year. This suggests that treatment with therapeutic RUF can prevent the development of severe malnutrition.

“We saw in 2005 and 2006 that giving mothers the responsibility for treating uncomplicated acute malnutrition produces good results. It is only when a child is ill or severely malnourished that treatment takes place in medical facilities.” Isabelle Defourny, Deputy Manager of the nutritional programme in Maradi, Niger.

This year, MSF went one step further and implemented a new two-tiered approach: earlier access to treatment for severe cases and earlier access to supplemental RUF for all children at risk in the area.

© Virginie Amehame

MSF began using the World Health Organization’s new growth standards to define admission criteria, which are more “inclusive” (some children formerly considered moderately malnourished based on the former reference are now classified as severe) and therefore include more children at high risk of death. Based on these new standards, children suffering from severe acute malnutrition are treated with therapeutic RUF in outpatient feeding centres. Only in cases of serious associated illness, are children hospitalised.

The second component of MSF’s new approach involves distribution of supplemental RUF, which does not replace regular meals but compensates for major deficiencies in their regular diet by meeting a child’s daily nutrient needs. MSF is distributing supplemental RUF to all 62,000 children from six months to three years of age in one district in Maradi on a monthly basis during the seasonal hunger gap.

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Therapeutic RUF

History of Therapeutic RUF