Comparison of Project Peanut Butter and Ghana Health Service Malnutrition Management Protocols in Brong Ahafo, Ghana
| Project Peanut Butter Protocol | Ghana Health Service CMAM Protocol | |
|---|---|---|
| SAM enrollment criteria | MUAC <11.5 cm or WLZ < −3 SD Bilateral pitting edema | MUAC <11.5 cm or WLZ below −3 SD Bilateral pitting edema |
| MAM treatment MUAC ≥11.5 cm, <12.5 cm WLZ between −2 and −3 SD | Enrolled and treated with RUTF | Increased nutrition counseling during CWC |
| RUTF dosage | 150 kcal/kg/day for SAM 75 kcal/kg/day for MAM | 200 kcal/kg/day for SAM |
| Follow-up | Biweekly | Weekly |
| Graduation criteria | MUAC >12.4 cm, or WFL > −2 SD for 1 visit (2 weeks) | MUAC >12.4 cm, 3 consecutive weeks No edema, 3 consecutive weeks |
| Discharge criteria | 3 consecutive visits missed (6 weeks) | 3 consecutive weeks missed |
| Maximum duration of treatment | 12 weeks | 16 weeks |
Abbreviations: CMAM, community management of acute malnutrition; CWC, Child Welfare Clinics; MAM, moderate acute malnutrition; MUAC, mid-upper arm circumference; RUTF, ready-to-use food; SAM, severe acute malnutrition; WLZ, weight-for-length z score.