What is Global Acute Malnutrition (GAM)?
Global Acute Malnutrition (GAM) is a key indicator used to assess the severity of a humanitarian crisis, representing the total number of children with both moderate and severe acute malnutrition. It is measured using anthropometric data like weight-for-height and mid-upper arm circumference (MUAC), along with checking for edema. The resulting prevalence rate informs the level of crisis and the needed response.
The Humanitarian Spectrum of Malnutrition
Humanitarian organizations classify nutritional situations on a scale ranging from stable to emergency and famine. This spectrum includes:
- Very Low: GAM below 2.5%.
- Low: GAM between 2.5% and 5%.
- Moderate: GAM between 5% and 10%.
- High: GAM between 10% and 15%.
- Very High (Emergency Threshold): GAM over 15%.
A GAM prevalence above 30% in children under five is one criterion for declaring a famine. These classifications guide resource allocation and intervention strategies.
Understanding the Types of Acute Malnutrition
Acute malnutrition, also known as wasting, is a severe short-term condition. It includes Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM). SAM is the most serious form. An individual SAM diagnosis uses weight-for-height z-scores, MUAC measurements, or the presence of edema. A SAM prevalence over 2% is also often an emergency indicator.
Factors Influencing the Emergency Threshold
The 15% GAM figure is a benchmark, but not a strict rule. Contextual factors play a significant role:
- Aggravating factors: A GAM of 10-14% combined with factors like displacement or high disease prevalence can trigger an emergency response.
- Population density and context: The scale of the affected population impacts the interpretation of a GAM rate.
- Vulnerability: The nutritional status of groups like children under five is a key concern.
- Resources: The availability of treatment resources influences how thresholds are acted upon.
Intervention Strategies Based on Thresholds
Interventions are scaled based on the severity level to effectively allocate resources and save lives. Strategies typically involve:
- Prevention: Promoting maternal and child nutrition, healthy feeding, and micronutrient supplementation.
- Treatment: Providing outpatient and inpatient therapeutic feeding for SAM and MAM, often using ready-to-use therapeutic food (RUTF).
- Integrated services: Combining nutrition with healthcare, WASH, and other essential services to address underlying causes.
Comparison of Malnutrition Thresholds
| Indicator | Thresholds | Significance | Intervention | Reference |
|---|---|---|---|---|
| Global Acute Malnutrition (GAM) | > 15% | High prevalence; triggers an official nutritional emergency | Scaling up preventive and treatment interventions | |
| 10-14% | Serious situation; can trigger an emergency response with aggravating factors | Focused intervention, close monitoring | ||
| > 30% | Extremely high prevalence; one criterion for declaring a famine | Large-scale, rapid, life-saving interventions | ||
| Severe Acute Malnutrition (SAM) | > 2% | Considered an emergency indicator by some organizations | Urgent and focused therapeutic treatment | |
| MUAC < 115mm | Individual diagnostic criteria | Immediate admission to a treatment program | ||
| WHZ < -3 SD | Individual diagnostic criteria | Inpatient or outpatient care, depending on complications | ||
| Contextual Factors | Aggravating factors (e.g., epidemics, displacement) | Can lower the effective threshold for declaring an emergency | Prioritization and rapid response |
Conclusion
The emergency threshold for malnutrition, primarily a GAM rate over 15%, is a crucial tool for guiding humanitarian response. Applying this threshold requires considering contextual factors and the needs of vulnerable populations. Understanding these thresholds is vital for effective humanitarian action. {Link: UNHCR Emergency Handbook https://emergency.unhcr.org/export-epub-entry/477}
