Acute malnutrition: Early diagnosis, thorough treatment, and family support are key

This adorable little girl's name is Amirlan Mungunzul. She is 2 years and 5 months old. She is the 4^th child in the family of 5 children. Today, her mother is smiling brightly, but there have been many tough days.

"Although my daughter was 2 years old, she still couldn’t walk on her own and had delayed speech development. So I was worried something was wrong, so I took her to the family practitioner and discovered that she was stunted and malnourished," says her mother, Mungunzul D.

Every year in Mongolia, more than 7,400 children under 5 suffer from acute malnutrition. Of these, about 1,900 have severe acute malnutrition (SAM). A child with SAM is 12 times more likely to die because malnourished children are more vulnerable to infectious diseases and complications. If malnutrition is not properly diagnosed and treated early, it can negatively affect the child`s quality of life, causing them to lag behind their peers in both physical and mental development. UNICEF remains the only organization that procures therapeutic milk and ready-to-use therapeutic food (RUTF) for SAM treatment.

"To detect malnutrition in infants and young children, we measure their weight-for-height, mid-upper arm circumference, and check for edema in both legs. If the child is not malnourished, the weight-for-height is normal, the mid-upper arm circumference (MUAC) is greater than 125 mm, and there is no edema in both legs. When we first assessed Amirlan, her MUAC was 11 cm and her height-for-weight ratio was low, but she didn’t have edema in both legs. Therefore, she was diagnosed with acute malnutrition. We recommended that she be given RUTF, a peanut-based paste, as part of her a unique treatment for acute malnutrition," says family practitioner Tungalagtuya G. 

"I started giving her RUTF as recommended by the family practitioner. The doctor explained that RUTF is not just food, but also medicine for malnourished children and should not be shared with other family members. She explained that when your child is malnourished, they have a reduced appetite, and showed me how to give it to her little by little and more frequently" said her mother, Mungunzul D.

Throughout the treatment, Amirlan`s progress was closely monitored by the physicians at the Family Health Center, who provided ongoing guidance.

"After 2 months of RUTF, my daughter's health started to improve. She gained weight, her appetite improved, and she started walking on her own. She has also started expressing herself with words. I am very happy to see these good results from using RUTF," said her mother.

Amirlan successfully completed the treatment for acute malnutrition thanks to the efforts of her family and the support of the physicians of the Family Health Center. Today, she is as healthy and active as other children her age.

Identifying children with acute malnutrition early through regular screenings, taking immediate action to address their nutritional needs, and providing comprehensive treatment significantly increases their chances of survival and healthy development The support and involvement of healthcare professionals and families are essential.

UNICEF supports the early detection and treatment of children with acute malnutrition, and has helped develop and approve of clinical guidelines for the diagnosis and treatment of SAM.

Moreover, training on detection and treatment of acute malnutrition is regularly offered in both urban and rural health centers. This has led to regular screenings and prompt treatment for children in both city and rural areas, often through home visits or Family Health Center consultations.

In 2023 alone, more than 630 children under 5 were diagnosed and treated for acute malnutrition in 3 remote provinces and 6 districts in the Ulaanbaatar, Mongolia.

"UNICEF continues to procure therapeutic milk and RUTF for treating severe acute malnutrition, MUAC tape, and height and weight scales every year based on the needs of the healthcare institutions. In fact, the cost of treating of severe acute malnutrition should be reflected in the state budget, just like other essential pediatric treatments, and should be a part of the child health services. Pediatricians and physicians from  Family Health Centers and General Hospitals both in the provinces and in the capital city frequently turn to UNICEF asking whether we have therapeutic milk and RUTF to spare because they have more children requiring immediate treatment. Every year, we procure certain amount of ready-to-use therapeutic food and therapeutic milk through UNICEF's Supply Division. However, in some cases, due to a lack of funding, we procure them in smaller quantities that do not meet the demand," says Munkhjargal L., the Nutrition Specialist at UNICEF Mongolia.

Leaving malnutrition untreated poses a significant risk to the child's lifelong health, quality of life, and even survival. Early detection and thorough treatment ensure the child's right to survival, growth, and development. Therefore, UNICEF is working with the government to ensure that the cost of therapeutic milk and ready-to-use therapeutic food for the prevention, detection and treatment of severe acute malnutrition is reflected in the state budget.