INTEGRATED  
                MANAGEMENT OF 
                 CHILDREN WITH  
          ACUTE MALNUTRITION IN 
                  SOUTH AFRICA 
        OPERATIONAL GUIDELINES 
                     2015 
     
     
     
    INTEGRATED MANAGEMENT OF CHILDREN WITH ACUTE MALNUTRITION IN SOUTH 
    AFRICA: OPERATIONAL GUIDELINES 
    First Print 2015 
    ISBN: 978-0-620-61970-7 
     
      NOTE: 
     The information presented in these guidelines conform to the current practices. Contributors and editors cannot be 
      held responsible for errors and other consequences. 
     
    Copyright:  Department of Health 2015 
    Any part of this material may be reproduced, copied or adapted to meet local needs, without 
    permission from the Department of Health, provided that parts reproduced are distributed free of 
    charge or not for profit. 
    Published by: National Department of Health 
    Suggested citation: National Department of Health. Integrated management of children with 
    acute malnutrition in South Africa: Operational guidelines. 2015. Pretoria, South Africa. 
    Formatting and Editing by: Gwen Wilkins, Reducing Maternal and Child Mortality through 
    Strengthening Primary Health Care in South Africa Programme (RMCH) 
    Printed by: Reducing Maternal and Child Mortality through Strengthening Primary Health Care in 
    South Africa Programme (RMCH) 
    Copies may be obtained from: 
           Directorate Child Health and Nutrition 
           Private Bag x828 
           Pretoria 
           0001 
      OR 
           Online at: www.doh.gov.za or www.rmchsa.org 
     
    Cover photo: Training course on the Management of Severe Malnutrition, WHO 
     
     
     
     
                 
                 
                                                        ii 
     
      
      
      
      
                                      
                                      
                                      
                                      
                                      
                                      
                                      
                                      
                                      
     INTEGRATED MANAGEMENT OF CHILDREN WITH ACUTE MALNUTRITION IN 
                  SOUTH AFRICA: OPERATIONAL GUIDELINES 
                                      
            STANDARD TREATMENT GUIDELINES FOR SOUTH AFRICAN 
               HOSPITALS AND PRIMARY HEALTH CARE FACILITIES 
      
                2015 EDITION 
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
                                                                    iii 
      
     
     
     
     
     
    FOREWORD 
    ‘There can be no keener revelation of a society’s soul than the way in which it treats its children.’ 
                                                Tata Nelson R Mandela 
     
    The health and wellbeing of our children are among our highest priorities. We need policies and actions that meet the 
    priorities, in order to ensure children are saved from preventable death as a result of moderate and severe acute 
    malnutrition. The World Health Organization (WHO) published the first guidelines to prevent severe malnutrition in 2000. 
    The community of Mount Frere in the Eastern Cape was one of the pilot sites used to inform these WHO guidelines. 
    Considerable evidence has since been accumulated with the latest WHO recommendation released in November 2013. 
    These guidelines have been adapted from the WHO recommendations into the local South African context and 
    incorporated all the recent evidence. 
    The integrated management of acute malnutrition, and especially the management of severe acute malnutrition, is one 
    of  the  key  evidence-based  nutrition  interventions  identified  in  the  2008  Lancet  series  on  Maternal  and  Child 
    Undernutrition. Scaling up the implementation of management of severe acute malnutrition in healthcare facilities using 
    the WHO guidelines can reduce case-fatalities related to this condition by 55%. Attention to the continuum of maternal 
    and child undernutrition is essential to attainment of Millennium Development Goal of reducing child mortality and must 
    be prioritised. Among other interventions are breastfeeding, complementary feeding and vitamin A supplementation. 
    Such interventions are incorporated in these guidelines for therapeutic treatment and further prevention of acute 
    malnutrition.  
    We are grateful to everyone who actively participated in the formulation and adaptation process of these guidelines by 
    submission of comments and appropriate evidence. This has been made possible by various stakeholders with different 
    technical expertise in the area of child health and nutrition. We acknowledge the technical support that has been 
    provided by our partners in the development of these guidelines. For this, I thank you. 
    We call upon all stakeholders to implement these guidelines in order to contribute towards achieving the goal of reducing 
    child mortality and promoting a long and healthy life for our citizens, especially our children. 
     
     
     
    Dr A Motsoaledi, MP 
    Minister of Health 
    Date:  
      
                                                          iv