MODULE 3

Community Mobilization

Resource Speaker
Designation
 At the end of the module, the
participant will learn how to…

• Describe community mobilization and its stages

• Discuss the process of engagement with the community
• Describe the process of developing key messages and
community sensitization
• Discuss finding of cases of acute malnutrition in the community
• Discuss patient referral for treatment and follow-up at-risk cases
of moderate and severe acute malnutrition at home when
needed
 Community Mobilization
• Vital part of MAM and SAM
management

• Finds children with MAM and SAM

and protects from deterioration or
death

• Engage with community to promote

understanding of PIMAM

• Promotes PIMAM services for

prevention & treatment
 Community Mobilization (cont.)
• Timely detection, treatment and
warranted referral of children with
MAM and SAM

• Ensures continuity of treatment

until each child is cured
Stages of Community Mobilization
Session 1.
Community Assessment
 Community Assessment
• Assess capacities of community in health, nutrition and
community awareness of malnutrition
• Interviews and FGDs with key community informants
Elements of Community Assessment
Session 2.
Community Sensitization
and Developing Key
Messages and Materials
 Community Sensitization and Developing
Key Messages and Materials

• Develop community sensitization plan

• Review plan with key people in community
• Conduct community dialogue
• GOAL: ALL children with MAM and SAM will have access to
treatment
Key Information in Sensitization

MAM/
MAM/

MAM and MAM and

Information, Education &
Communication Materials

RUTF RUSF
GROUP WORK- Community Sensitization
• Form into 4-5 groups.
• Assign a rapporteur in each group.
• Each group should discuss the following:
▪ Own community’s experience/perceptions on MAM and SAM
▪ Information on signs and symptoms, identification, treatment of MAM
and SAM, etc.
• Create a Community Sensitization Plan (in the form of a flyer)
• Rapporteur will report after 20 minutes.
• Only 2 groups will present their flyers (chosen by lottery)
Session 3.
Training and Case Finding
At the end of the Session, you will be able to identify MAM and
SAM patients at the community level.
Stages of Community Mobilization
Training
 Case Finding
• Screen children regularly
• Identify MAM and SAM when it is most easily treated

• Types of case finding

▪ Active
▪ Passive
▪ Active adaptive
 Severe Acute Malnutrition

Children MUAC is Presence of

aged 6-59 less than bilateral
months 11.5 cm pitting
edema
Moderate Acute Malnutrition

Children MUAC is Absence of

aged 6-59 11.5 cm to bilateral
months 12.4 cm pitting
edema
 Who can we involve?
• Local Nutrition Committee/Cluster
• BNSs, BHWs, midwives and RHU staff
• Barangay Council for the Protection of
Children (BCPC) members
• Municipal and Barangay Social Workers
• Early Childhood Development Center
(ECCD) staff and Facilitators
• Caregivers’ Group Members and
individual caregivers
• Barangay assemblies
• And more...
 BARRIERS
•Lack of knowledge about malnutrition
•Lack of awareness that treatment is
available
•Distance to treatment is too far
•Caregivers’ workload
•Caregivers take child to other places thus
delaying treatment when MAM and SAM
are identified
•Physical barriers (mountains, rivers,
landslides)
•Climate (heat, monsoon rains)
•Poor standard of treatment
•Service is not valued by the community
•Shortages of medicines, RUSF & RUTF
BOOSTERS
•Knowledge about acute malnutrition
•Awareness that treatment is available
locally
•Caregivers take children to the health
center for treatment quickly when MAM
and SAM are identified
•Good standard of treatment
•Good community support for service
•Good supplies of medicines, RUTF,
RUSF or locally available foods
comparable to RUSF in calorie and
nutrients
BARRIERS Number of children with MAM
and SAM who are being treated
& COVERAGE = -------------------------------------------
Total number of children existing in
the community with MAM and SAM
BOOSTERS
Session 4.
Referral and Follow-up
 REFER TO NEAREST
Once a child is identified TREATMENT POINT:
with SAM - RHU or
- Barangay Health Station
 REFER TO NEAREST
Once a child is identified
Supplementary Feeding
with MAM
Center, RHU or BHS
Barangay Health Worker/
Barangay Nutrition Scholar

BHW/BNS

Identify MAM & Provide Refer MAM

Screening
SAM Counseling & SAM
Barangay Health Worker/
Barangay Nutrition Scholar
 Follow-up

• Home visits, follow-up of cases who have been absent,

recovering slowly, or are at risk of defaulting
• Good linkage between the community and health facilities
• BNS/BHW links with the midwife, public health nurse and
other facility staff
 Follow-up should focus on the
following...
• Children with medical complications who refuse transfer to
inpatient care and are treated on an outpatient basis
• Children who are not responding (losing weight or not gaining
weight for two weeks) and live in difficult home environment
• Repeated absentees from treatment
• Infants less 6 months old not gaining weight during a period
of IYCF counselling
 REFER THESE CHILDREN IMMEDIATELY TO
NEAREST HEALTH FACILITY!

Eating less than 50% General

of the daily ration
(RUTF, RUSF or deterioration in
local food) health

Untreated
persistent
Any weight loss
vomiting or
diarrhea
 REFER THESE CHILDREN IMMEDIATELY
to hospital:
CHECK FOR GENERAL DANGER SIGNS
ASK: LOOK:
•Is the child able to •See if the child is
drink or breastfeed? lethargic or
•Does the child vomit unconscious
everything? •Is the child convulsing
•Has the child had now?
convulsions?

both MAM and SAM with any IMCI Danger Sign

and SAM with a lack of appetite for RUTF
 SAM MAM
Each weekly visit… Every 2 weeks visit…
•Measure MUAC, weight and check for edema; •Measure MUAC, weight and check for edema;
•Check MUAC and WHZ (if appropriate) for discharge •Check MUAC and WHZ (if appropriate) for discharge
criteria criteria
•Take body temperature •Take body temperature
•Do the appetite test •Appetite test- NOT NEEDED
•Ask about the progress of the child •Ask about the progress of the child
•Check IMCI danger signs •Check IMCI danger signs
•For infants < 6 months old, ask about breastfeeding •For infants < 6 months old, ask about breastfeeding
practice and any improvement in milk production practice and any improvement in milk production
•Give routine treatment at the appropriate visits •Give routine treatment at the appropriate visits
•Complete the OTC chart •Complete the SFP chart
•Make any necessary referrals •Make any necessary referrals
•Recalculate the weekly RUTF ration according to •Check for “failure to respond” signs and double
current weight and provide the ration ration size for 2 weeks then follow-up next visit
 Each home visit….
• Discuss with the caregiver to help her/him understand the constraints that
they are operating under and offer suggestions/support
• For infants <6 months, ask for breastfeeding concerns and observe if
attachment and positioning are effective
• Do any appropriate counseling/referral
• Link clients to livelihood/safety net/social protection programs available
• Record all relevant information and give feedback.
▪ If the child has stopped attending treatment against a health worker’s
advice, note down the reasons for defaulting
ANY QUESTIONS?
Summary:
• More children get treatment for MAM and SAM if community leaders
are sensitized and mobilized
▪ Engagement with the community
▪ Developing key messages and community sensitization
• The community can be mobilized to increase awareness and identify
cases of acute malnutrition in the community
• Strong community linkages facilitate patient referral for treatment
and follow-up of MAM and at-risk cases of severe acute malnutrition
at home when needed