Post Cyclone Idai Evaluation of the Integrated Management of Acute Malnutrition (IMAM) Programme for Children under Five in Chimanimani, Zimbabwe

Abstract

Background: Natural disasters like cyclones have been shown to cause food insecurity and infectious diseases leading to malnutrition. Objective: To evaluate the point prevalence of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) and post cyclone Idai Integrated Management of Acute Malnutrition (IMAM) response in Chimanimani district. Methods: A stratified random sampling method was used to select mother/child pairs who were IMAM beneficiaries. Clinic level records and reports on admissions and treatment outcome statistics were collected. Stories of most significant change (MSC), Focus Group Discussions (FDG) and Key Informants interviews were conducted. Results: At baseline, 74 children were admitted as malnourished, 25 had SAM and 49 had MAM, the number reduced to 45 with 13 SAM and 32 MAM four months post cyclone. The impact of the intervention was measured by the quality of treatment outcomes. The average cure rate from April to December for MAM was 79%, defaulter rate 19%, non-recovery 0%, died 2% and for SAM, cure rate 82%, defaulter rate 13%, died 0% and non-recovery 5%. The cure rate, non-recovery rate and death rate were in line with the SPHERE minimum standards Conclusion: The prevalence of SAM and MAM were highest two months after the cyclone with a marked reduction of cases 4 months post cyclone. The cure, death and non-recovery rate outcome indicators were desirable; however, defaulter rate compromised the effectiveness of the IMAM programme. These findings warrant the strengthening and establishment of effective defaulter follow up systems in displaced and hard to reach areas.