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MAMI Practice

The MAMI Care Pathway Package (2021, Version 3) is a set of resources and materials that was co-created by members of the MAMI Global Network. Previously known as the C-MAMI Tool, the update was informed by the latest evidence and experiences of putting previous versions into practice. The MAMI Care Pathway Package is intended to help operationalize the 2013 World Health Organization guidelines on the management of severe malnutrition in infants under six months. It provides implementation guidance on how to identify, assess, and support small and nutritionally at-risk infants under six months and their mothers and materials to help practitioners put this into practice. The overall approach and format of the package is modelled on and supports the implementation of Integrated Management of Childhood  Illnesses (IMCI).

For more details on the contents of the package, watch part 2 of the MAMI CP orientation on the MAMI Global Network Youtube channel. 

Version 2 was piloted in Bangladesh (Save the Children), Ethiopia (GOAL) and Rwanda (Partners in Health) and these experiences have informed the 2021 update. The following articles and papers describe these experiences:

• Piloting the tool in the Rohingya response in Bangladesh (Save the Children)
• Follow up of vulnerable infants in Rwanda (Partners in Health)
• Short video developed by Save the Children sharing field experiences from Save the Children and GOAL in Bangladesh and Ethiopia
• Cost of implementing MAMI in Bangladesh
• GOAL’s experiences of implementing the Family MUAC approach for infants under 6 months in the context of COVID-19 in Ethiopia
• Special section in ENN’s Field Exchange

Tabitha Van Immerzeel, a medical doctor in Senegal and chair of the MAMI Researchers Group, has led a multi-country stakeholders' analysis on the feasibility of the MAMI Care Pathway. This paper consulted 189 stakeholders from 42 countries on the feasibility of implementation of the MAMI Care Pathway, and potential enablers and barriers.

Key findings:

• The MAMI Care Pathway is relatively unknown in countries but was identified as needed and feasible, with adaptation to the local context considered crucial to further scale-up.
• Implementation barriers identified included community-specific needs and healthcare-seeking barriers, health workers’ lack of competence in breastfeeding counselling and the need for more evidence on anthropometric screening methods.
• Possible enablers to implementation included patients’ preference for outpatient care, the integration of the care pathway into existing structures and the possibility of a local pilot project.

Useful programming resources

• Guidance Note on Save the Children’s Monitoring, Evaluation, Accountability & Learning Tools for MAMI implementation
• Facilitator's guide and presentation: orientation workshop on MAMI 
• Review of anthropometric indicators to assess acute malnutrition in infants under six months
• MAMI MUAC tapes
• Guidance on Wasting and COVID-19 Programme Adaptations Information Note 005 produced by the Wasting Thematic Working Group of the Global Nutrition Cluster Technical Alliance with the support of MAMI Global Network
• GOAL's Adapting to COVID-19 Resources for Charities - these include MAMI programme adaptations document and a series of MAMI Nutrition Posters.
• Compiled resources from the Caregiver Mental Health Knowledge Sharing Series including intervention approaches, guidelines and tools, organisations and networks, and selected research and publications.

Support available

The Network facilitates support to service providers, policymakers and researchers through the following mechanisms:

• To help support programmers, ENN’s online technical forum en-net includes a MAMI thematic area. Please post any technical questions you may have, and someone from the MAMI community will respond.
• For any government, individual or organisation implementing MAMI services, or actively planning to do so, join the MAMI Implementers special interest group. This group meets monthly online to discuss MAMI programming, seeking support and advice from peers. For more information or to join, please contact us at mami@ennonline.net.
• For any MAMI related study, project or guideline update, request for representation from the Network on an advisory group will be considered depending on the terms of reference and available capacity. For more information, please contact us at mami@ennonline.net.
• Save the Children provide MAMI technical expertise to the GNC TA both remotely and in-country for those who require support on implementation of the MAMI Care Pathway. Requests can be sent via: https://ta.nutritioncluster.net/request-support.

Reference this page

MAMI Practice. www.ennonline.net/mami/practice

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