guidelines for the integrated management of severe acute malnutrition

ACF-In Guidelines for the integrated management of SAM Annexes 146
- Phase 2: similar to phase 1
- Low weight phase: a separate phase must be foreseen for the smallest babies, as they are too
much at risk of attracting infections when mixed with the other children. Their phase must be in
the warmest part of the TFC, close to the nurses. The room/tent must be protected from drafts
and water.
- Kitchen: for preparation of meals of milk and family meal. If day-care, but beneficiaries stay
overnight, a small cooking area must be foreseen for mothers to cook in the evening. The
kitchen must be airy, but well protected against insects. It must have stoves in according to the
quantity of food that needs to prepared, a table, a cupboard that can be closed and it must in
nearby a water tap for washing up and drying
- Play room: an area where children can play, and psycho-social sessions can be held
- Central shelter: a central shelter, just a roof, where mothers can sit outside when it is too hot in
the tents and chat, play with the children, have the health education sessions etc.
- Health education room: if sufficient space & budget is available, a special health education
room can be added, but if other spaces are available for this activity, it is not absolutely
necessary
- Stock: a stock sufficiently big for the food, drugs and material that will be kept in the centre. A
good door and locking system.
- Latrines & showers: A number of latrines & showers, accordingly to the number of
beneficiaries and staff expected to be present, must be available. The showers must have a
good evacuation system. The latrines must be well lit at night
- Washing area: an area with water taps, some concrete slab and a drainage, where caretakers
can wash their clothes, especially needed if 24h care, or if people stay overnight; but also
needed if day care, so mothers can perform their daily tasks in the centre
- Hand washing and drinking points: a water source must be available to make sure there is
enough water to drink for beneficiaries and to fill the hand washing points (min. one at the
nurse, one at the premix room, one at the exit of latrines). If there is an epidemic of cholera or
other diarrhoeal of infectious diseases, more hygiene measures must be taken (pediluves,
spraying,…)
- Isolation area: in areas where there is an epidemic on-going (measles, dysentery,…) or where
other contagious diseases are common, an isolation area is obligatory, in other situations it is
more than advisable to have it just in case. The isolation area should consist of 1 or more
rooms/tents (in case isolation is needed for more than one disease) with separate latrines and
showers, and a way of fencing it off from the rest of the centre. Make sure that it is comfortable
enough (with some space outside etc.) so that isolated people do not feel imprisoned.