What are the components of the CMAM?

January 1, 2026 •

3 min read

Globally, severe wasting affects an estimated 16.4 million children, highlighting the critical need for effective interventions such as the Community-based Management of Acute Malnutrition (CMAM). This framework uses a decentralized, community-focused approach to combat acute malnutrition, reaching more children than traditional, facility-based methods alone.

Quick Summary

The Community-based Management of Acute Malnutrition (CMAM) framework consists of four primary components: community outreach, outpatient therapeutic programs, inpatient stabilization centers, and supplementary feeding programs.

Key Points

Community Outreach: Trained community health workers use simple tools like MUAC tapes to find, screen, and refer children with malnutrition.
Outpatient Therapeutic Program (OTP): Treats children with uncomplicated severe acute malnutrition at home using ready-to-use therapeutic food (RUTF).
Inpatient Care / Stabilization Centers (SCs): Provides intensive, 24-hour care for children with severe acute malnutrition complicated by medical issues.
Supplementary Feeding Program (SFP): Provides nutritional support to children with moderate acute malnutrition to prevent their condition from deteriorating.
Continuum of Care: All four CMAM components are interconnected, ensuring a smooth referral process and providing a complete treatment pathway for children.
Local Empowerment: The model empowers local community health workers and caregivers to play an active role in managing malnutrition cases, improving accessibility and ownership.

The Four Key Components of CMAM

The Community-based Management of Acute Malnutrition (CMAM) model is built upon four interconnected components that provide a continuum of care for children affected by acute malnutrition. This integrated approach ensures that resources are used efficiently and that care is accessible to as many children as possible within a community. The components are:

1. Community Outreach and Mobilization

Community Outreach is the initial stage, focusing on identifying and referring children with acute malnutrition before they reach a clinic. Trained community health workers use tools like the Mid-Upper Arm Circumference (MUAC) tape for screening and educate communities on malnutrition signs and available services.

2. Outpatient Therapeutic Programme (OTP)

The OTP treats children with severe acute malnutrition (SAM) who are without complications and have an appetite, allowing them to receive home-based care. Key elements include the use of Ready-to-Use Therapeutic Food (RUTF) and regular check-ups at local health facilities for monitoring and resupply.

3. Inpatient Care / Stabilization Centers (SCs)

Inpatient care is for the minority of children with SAM who have medical complications or a poor appetite. Located in health facilities, SCs provide intensive medical and nutritional treatment, stabilizing the child before they can transition to outpatient care.

4. Supplementary Feeding Program (SFP)

The SFP targets children with moderate acute malnutrition (MAM) to prevent their condition from worsening, and also supports other vulnerable groups. This involves providing supplementary food like Ready-to-Use Supplementary Food (RUSF) and monitoring their health status.

Comparison of CMAM Treatment Programs

The CMAM framework uses a tiered approach, with specific programs for different levels of malnutrition severity. A comparison of the two main therapeutic programs is detailed below.


Feature	Outpatient Therapeutic Program (OTP)	Inpatient Care / Stabilization Centers (SCs)
Target Patient	Children with uncomplicated Severe Acute Malnutrition (SAM) and good appetite.	Children with complicated Severe Acute Malnutrition (SAM) or a poor appetite.
Location	Community-based health facilities or designated sites.	Hospital-based stabilization centers.
Treatment Focus	Nutritional rehabilitation using Ready-to-Use Therapeutic Food (RUTF) and routine medication.	Intensive medical treatment for complications and therapeutic milk (F-75/F-100).
Care Delivery	Primarily home-based treatment with weekly or bi-weekly check-ups.	24-hour supervised care by medical staff.
Duration	Typically takes several weeks until recovery criteria are met.	Short-term stay, transitioning to OTP once stabilized.
Cost-Effectiveness	Highly cost-effective due to decentralized, non-intensive care.	High cost due to intensive, 24-hour medical care.

The Integrated Nature of CMAM Components

The strength of the CMAM approach lies in the seamless integration and referral system between its components. Children move between community outreach, OTP, and SCs based on their medical condition, ensuring continuous care. This interconnected system prevents treatment gaps and ensures children receive appropriate care at the right time. Resources like the World Health Organization (WHO) and UNICEF provide further guidelines on CMAM.

Conclusion

CMAM is a comprehensive strategy with four key components—community outreach, outpatient care, inpatient stabilization, and supplementary feeding—working together to treat acute malnutrition. This integrated, decentralized model significantly increases access to care and improves recovery rates, saving lives globally. CMAM demonstrates the effectiveness of community-centered approaches in public health.

Frequently Asked Questions

The primary goal of the CMAM approach is to provide effective, community-based treatment for acute malnutrition, thereby increasing access to life-saving care and reducing child mortality, especially for severe cases.

Unlike traditional, centralized feeding centers that require long stays in a hospital setting, CMAM allows most children to be treated at home through outpatient programs. This increases treatment coverage and reduces costs, overcrowding, and the risk of infection.

RUTF, or Ready-to-Use Therapeutic Food, is a high-energy, nutrient-dense paste used in the outpatient therapeutic program (OTP) for children with uncomplicated severe acute malnutrition. It is a home-based treatment that is safe and effective.

Inpatient care in a Stabilization Center (SC) is reserved for children with severe acute malnutrition who have medical complications, such as a high fever or severe edema, or those who have lost their appetite and cannot tolerate RUTF.

SAM (Severe Acute Malnutrition) is the more serious condition, requiring intensive treatment either at an OTP or SC. MAM (Moderate Acute Malnutrition) is a less severe form, which is managed through a Supplementary Feeding Program (SFP) to prevent it from worsening.

Community outreach is typically conducted by trained community health workers, volunteers, and health staff who actively screen children in their communities. This ensures early detection and referral for treatment.

After a child recovers and meets the discharge criteria, they are exited from the program. Ongoing support often includes counseling on infant and young child feeding (IYCF) practices to help prevent future malnutrition.