Six years after the introduction of community-based management of acute malnutrition (CMAM) in Nigeria, the country is entering a key stage in its fight against severe acute malnutrition (SAM). After an accelerated scale-up process that has seen the roll out of CMAM services across the northern states and the admission of over 1,000,000 SAM cases, sufficient evidence has been generated to analyse the successes, challenges and lessons that must shape the future of SAM management in Nigeria.

This review was carried out by Action Against Hunger (ACF) with the support of the Children’s Investment Fund Foundation (CIFF). Its goal is to help policy makers and practitioners answer some fundamental questions about the scale of the SAM problem in Nigeria, the performance of CMAM services to-date, and its implications for the future of SAM management in Nigeria and beyond.

The review builds on a range of data sources, from information originally reported by local governments and collected by the Ministry of Health (MoH) and UNICEF, to first-hand data collected by ACF, Save the Children and Valid International through direct coverage assessments in the field. The review benefited not only from the recent availability of CMAM coverage information from across northern Nigeria, but also from the ability to invest in data collection to answer some of the questions that emerged during the course of the analysis.