Feb 2017 – Nov 2019

Improving efficiency of SAM treatment in Nigeria



Nigeria – Africa

To reduce the cost of treating severe acute malnutrition by demonstrating that it is possible to switch from weekly to monthly treatment visits without compromising recovery outcomes for children.

$1,399,912 Grant Value

Severe acute malnutrition (SAM) causes between 500,000 to 1,000,000 deaths each year, representing between 8-16% of all under five mortality. Despite the availability of effective treatment through Ready to Use Therapeutic Food (RUTF) and a proven and successful model of delivery of treatment through community management of acute malnutrition (CMAM), challenges in addressing SAM still remain. There are 17 million children suffering from SAM, yet due to the high cost and lack of political will, only about 3.5 million are currently receiving treatment. 

Despite the revolutionary impact CMAM has had on the treatment of SAM, the current protocol on delivering treatment remains inflexible by requiring caregivers to travel to health clinics on a weekly basis. This places a time burden on health systems and caregivers as well as placing a financial burden on caregivers who bear the costs of travelling to health clinics. In Northern Nigeria, where this operational study is occurring, coverage is estimated to be as low as 36.6%. 

The investment aims to reverse these trends by fostering the uptake of an alternative SAM treatment protocol into policy and programmes at the local, national and global levels. This will be an improvement on the current treatment protocol. The investment will specifically assess the impact of reducing the number of times caregivers must travel to health clinics from a weekly to a monthly basis on SAM treatment outcomes.  


Through this investment, we expect to contribute to:

  • Increased SAM treatment coverage – up to four times the number of children can be treated by the clinic each month in theory but in practice, the immediate coverage levels raised are expected to be lower.
  • Improved cost effectiveness of SAM treatment– as coverage increases, the cost per child will decrease due to economies of scale being realised on the programme’s fixed costs – with the potential to reduce costs by as much as up to 30%.
  • An alternative model of delivering SAM treatment – the time and financial burden faced by programme users will be reduced.  

This investment forms a crucial part a multi-pronged innovation agenda to find practical ways of doubling the number of children treated for SAM to 6.2 million by 2020. It is expected to complement similar investments focused on reducing the cost and improving the efficiency of SAM treatment, particularly in reducing the cost of RUTF and simplifying treatment dosage.