Topic: MAMI (Management of small and nutritionally At-risk Infants under six months and their Mothers)

Lisez cet blog en français ici.

The much-anticipated 2023 WHO guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and children under 5 years has finally landed. Some of you have asked us, where’s MAMI? Rest assured it’s there!

Read an English version of this blog here.

Les très attendues directives 2023 de l'OMS sur la prévention et la prise en charge de l’émaciation et de l'œdème nutritionnel (malnutrition aiguë) chez les nourrissons et les enfants de moins de 5 ans sont enfin sorties. Certains d'entre vous nous ont demandé où était l’approche MAMI. Soyez rassurés : elle y est !

The recently launched Lancet Small Vulnerable Newborns (SVN) Series comprised three hearty papers of evidence and analyses and a call for action to prevent babies being born dead, too early and too small.

Présentation par Gwénola Desplats (Nutritionniste principale de ENN)

L’approche MAMI (d’après l’acronyme anglais) désigne la prise en charge des nourrissons de moins de six mois, petits et à risque nutritionnel, et de leurs mères.

Le Réseau mondial MAMI est un groupe de responsables de programme, de chercheurs et de décideurs politiques qui œuvrent à développer un réseau efficace et dynamique afin de renforcer leurs capacités mutuelles, de créer des passerelles entre les disciplines, de combler les lacunes en matière de données probantes et de faire le plaidoyer pour l’approche MAMI. Regardez et partagez notre nouvelle vidéo qui explique le travail du réseau et venez rejoindre un groupe de collaborateurs internationaux spécialisés qui œuvrent ensemble pour les nourrissons de moins de six mois, petits et à risque nutritionnel, ainsi que leurs mères.

MAMI is the management of small & nutritionally at-risk Infants under six months & their mothers.

The MAMI Global Network is a group of programmers, researchers and policymakers working to build an effective and energetic network to enhance mutual capacity, bridge disciplines, address evidence gaps and champion MAMI care. Do watch and share our new video explaining the work of the network and come join a dedicated group of international collaborators working together for small and nutritionally at-risk infants under six months and their mothers. We have three different voiceovers below for you to choose from.

At the beginning of August, ENN participated in a global webinar to mark World Breastfeeding Week organised by the Global Breastfeeding Collective (GBC), supported by UNICEF. During the webinar, we heard from experts on resources available to implement the Ten Steps to Successful Breastfeeding, learned from donors about why we need to invest in the Ten Steps, and were inspired by national and regional leaders’ experiences of applying the Ten Steps in their contexts. The ENN team then introduced the MAMI Care Pathway Package, as a useful resource to support implementation of Step 10 - Coordinate discharge so that parents and their infants have timely access to ongoing support and care – for small and nutritionally at-risk infants under 6 months and their mothers. We also had the pleasure of launching the Operational Guidance on Infant and Young Child Feeding in Emergencies 10-year Progress Report, produced by the IFE Core Group. To learn more about these initiatives, check out our recent blog where you can also watch the WBW webinar recordings, read a brief on breastfeeding as a safe, sustainable, climate-friendly resource on RTE Brainstorm and join the MAMI Global Network.

World Breastfeeding Week webinar and Q&A

The above video is the Africa, Europe and Asia Pacific recording, with a case study on Rwanda. 

In June 2022 at the MAMI Implementers Group meeting, Elise Vanlerberghe presented some thoughts on the maternal mental health component of the MAMI approach which will be implemented by MOMENTUM Integrated Health Resilience (MIHR) project and partners in South Sudan. Elisa looks at the tools for screening and assessment, considering their appropriateness for the context in South Sudan and suggested some possible alternatives.

The GNC technical Alliance and ADRA Yemen presented their MAMI pilot implementation experience. Watch this webinar to find out how they delivered services, what their challenges were and how they overcame them. Services were planned with the support of the GNC TA MAMI expert, whose support can be requested here

The slides for the presentation are available here and the Q&A answers here. 

In this video Dr Indi Trehan (Associate Professor, Pediatrics - Emergency Medicine, University of Washington) presented to the MAMI Global Network’s Implementers’ group the results of the study: ‘Community-Based Management of Acute Malnutrition for Infants Under 6 Months of Age is Safe and Effective: Analysis of Operational Data.’ 

On 19 November 2021, the MAMI Global Network hosted an official N4G side-event focused on partnerships and collective action to co-create evidence to transform care of small and nutritionally at-risk infants under six months and their mothers (MAMI). The event showcased country experiences from Ethiopia and India and featured reflections from the WHO and UNICEF on strategic approaches to transform MAMI care.  

Part 1: MAMI Care Pathway Package Overview

This video gives an overview of the MAMI Care Pathway Package - a set of resources and materials to help practitioners identify, assess, and manage small and nutritionally at-risk infants u6m and their mothers. The MAMI Care Pathway Package is a package of resources that was co-created by members of the MAMI Global Network, co-led by the Emergency Nutrition Network and the London School of Hygiene and Tropical Medicine. The MAMI Care Pathway was released in May 2021; previously known as the C-MAMI Tool, the update was informed by the latest evidence and experiences of putting previous versions into practice. Learn more about the contents of the MAMI Care Pathway Package in Part 2 of this video here.

Part 2: Contents of the MAMI Care Pathway Package.

This video looks in detail at the contents of the MAMI Care Pathway Package - a set of resources and materials to help practitioners identify, assess, and manage small and nutritionally at-risk infants u6m and their mothers. The MAMI Care Pathway Package is a package of resources that was co-created by members of the MAMI Global Network, co-led by the Emergency Nutrition Network and the London School of Hygiene and Tropical Medicine. The MAMI Care Pathway was released in May 2021; previously known as the C-MAMI Tool, the update was informed by the latest evidence and experiences of putting previous versions into practice. For an overview of the MAMI Care Pathway Package, see Part 1 of this video here. 

Tackling malnutrition is a global health priority, helping children both survive and thrive. A large proportion of infants under six months of age in the world are identified as malnourished (wasted, stunted and/or underweight) and are at increased risk of death, disease, and poor development. Challenges faced by frontline practitioners in supporting small and nutritionally at risk infants under six months and their mothers prompted the MAMI Global Network to develop the MAMI Care Pathway Package (formerly the C-MAMI Tool) to fill this urgent gap. 

This video is a presentation to the Ethiopian Nutrition Leaders Network Annual Meeting, 23rd November 2020 by Marie McGrath (ENN) and Carlos Grijalva Eternod (LSHTM).

MAMI RISE research in Ethiopia is a four year research programme (2019-2023) that will test the MAMI care pathway as a community based approach to care for nutritionally at risk infants under six months in a randomised control trial (RCT) within existing services in two sites in Ethiopia (Jimma Zone and Deder Woreda).

This is a recording of a presentation by Marie McGrath, ENN Technical Director, on ENN's work on Management of At risk Mothers and Infants under six months (MAMI). It shares key principles of the MAMI approach, how this collective effort has evolved, resources available to support practitioners and exciting potential looking ahead.

MAMI Special Interest Group meeting, December 2019 Report.

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Over the years the scope of ENN’s work has expanded beyond a focus on humanitarian contexts to encompass a broader set of issues around drivers of wasting and stunting in both high burden and emergency contexts. We are also increasingly interested in the evolving policy and programming environment around malnutrition treatment and prevention. ENN is currently engaged in exploring the relationship between wasting and stunting (see the recent blog piece by Carmel Dolan here), stunting in emergencies, and on how stunting or wasting focused initiatives interact in practice.

Read this blog in English

Au fil des années, la portée du travail d'ENN s'est étendue au-delà de l'accent mis initialement sur les contextes humanitaires pour englober un ensemble plus large de problèmes liés à l’émaciation et au retard de croissance dans des contextes d'urgence et/ou des contextes où la prévalence est élevée. Nous sommes de plus en plus intéressés par l'évolution de la politique et de l'environnement de programmation autour du traitement et de la prévention de la malnutrition. ENN est actuellement engagé dans l'exploration de la relation entre l’émaciation et le retard de croissance (voir le récent billet de Carmel Dolan sur le blog ici), le retard de croissance dans les situations d'urgence, et la façon dont les initiatives ciblées sur le retard de croissance et l’émaciation interagissent dans la pratique.

Lire ce blog en francais

I hope some of you have heard of No Wasted Lives. For those who haven’t, now is the time to join forces with this coalition of partners working to address the biggest challenges we face today in the prevention and treatment acute malnutrition.Our ambitions are large and we need your help to accelerate global action to double the number of children receiving treatment to 6 million a year by 2020.