This report reviews India’s progress in implementing community-based management of severe acute malnutrition (CMAM) for children under five, drawing on experiences from 12 states up to December 2019. CMAM complements facility-based care by enabling early detection and treatment at the community level for 85–90% of SAM cases that are not medically complicated. The document highlights state-wise progress, including pilots and scale-up in states such as Jharkhand, Gujarat, Rajasthan, Uttar Pradesh, Maharashtra, Madhya Pradesh, Bihar, West Bengal, Telangana, Chhattisgarh, Odisha, and Assam.
Key lessons include the critical role of community engagement for awareness and participation, the importance of convergence between government departments, and the need for timely enrollment and strong referral linkages between community and facility care. Operational challenges include incomplete child lists, poor measurement accuracy, faulty equipment, human resource shortages, and variable food quality. Recommendations emphasize strengthening capacity-building, supportive supervision, and post-discharge follow-up to ensure sustained recovery.
The report concludes that CMAM, if effectively implemented with strong monitoring, convergence, and community mobilization, can be a cost-effective, scalable solution for reducing severe wasting in India. COVID-19 has highlighted the urgency of integrating SAM management into essential health and nutrition services to maintain continuity of care during crises.