Participants will be able to: recognize importance and identify resources for learning about a country and local 'disease' profile; local/regional guidelines and algorithms appropriate for the specific clinical setting; how to address limitations in clinical resources for diagnosis and management of clinical cases; and understanding health care service structure and personnel/staffing structure.

5. The 20 countries with the highest burden of undernutrition

7. WHO: Management of Severe Malnutrition, 1999.

9. Observed relationship between MUAC and child mortality in five studies Briend , BMJ 1986 Mid-Upper Arm Circumference

10. Identifying Children with Acute Malnutrition If the color is red (MUAC below 11 cm), then the child is severely malnourished and need to immediately be taken to the nearest qualified health worker, health facility or hospital for assessment, treatment and follow up. If the color is yellow (MUAC below 12.5 cm), then the child is moderately malnourished and needs assessment and supplementary foods (additional enriched food). If UNIMIX/CSB is not available, follow the guidelines on good complementary food listed fact sheet “The best foods for children under 5” years Green color (MUAC above 12.5 cm) means that the child is healthy and not malnourished. This child should continue to eat the good foods listed in fact sheet “The best foods for children under 5” Check for Oedema

11. www.who.int

12. WHO. Management of severe malnutrition.

13. Normal SAM ORS R-ORS Na 75, glu 75 Re-So-Mal Rehydration 60 – 80 ml/kg over 4h 5 ml/kg every 30 minutes over 2h then 5 ml/kg/h over next 4-10 hours

18. MVI Daily, for at least 2 weeks Zinc 2 mg/kg/day Folic acid 5 mg day 1, then 1 mg/day Copper 0.3 mg/kg/day Iron Once gaining weight , 3 mg/kg/day

23. IMCI example chart

25. Bhutta, Lancet 2008 Proportional reduction in deaths before 36 months of age Relative reduction in prevalence of stunting at 36 months of age Millions of DALYs averted 99% coverage with balanced energy protein supplementation 2.9% 0.3% 7.1 (2.8%) 99% coverage with multiple micronutrient supplementation in pregnancy 1.6% 0.1% 4.0 (1.5%) 99% coverage with breastfeeding promotion and support 9.1% 0% 21.9 (8.6%) 99% coverage with vitamin A 7.2% 0% 17.6 (6.9%) Proportional reduction in deaths before 36 months of age Relative reduction in prevalence of stunting at 36 months of age Millions of DALYs averted General Nutrition Interventions 13.4% 15.5% 33.8 (13.3%) Micronutrient interventions 12.1% 17.4% 31.3 (12.3%) Disease control interventions 2.6% 2.7% 6.6 (2.6%)