Menu ENN Search

Management of At Risk Mothers and Infants (MAMI)

Donors:  Irish Aid

Collaborators: LSHTM, University of Washington, KEMRI-Wellcome Trust Project and CHAIN (Kenya), WHO, UNHCR, UNICEF, Save the Children, ACF, Goal, MSF, World Vision, Partners in Health, Integrowth/Interpractice, and independent experts and practitioners.

ENN project lead and contact: Marie McGrath

Timeframe: 2008 - ongoing 

 

MAMI (Management of At risk Mothers and Infants under 6 months) concerns the identification and care of at risk mothers and infants under 6 months, with particular interest in nutrition vulnerability. 

Our vision is that every infant under six months of age, at every community and health-service contact, is nutritionally assessed and appropriately supported to survive and thrive.

Quick links

C-MAMI tool, V2, 2018

MAMI special section, Field Exchange 58, September 2018 

MAMI Special Interest Group (SIG) meeting report, January 2018

Review of anthropometric indicators to assess acute malnutrition in infants under six months

MAMI thematic area, en-net

Background 

ENN begain working on the Management of Acute Malnutrition in Infants under 6 months (MAMI) project in 2008 prompted by challenges shared by NGOs in emergency contexts. This led to a two year ENN-led collaboration with University College London (UCL) and Action Against Hunger to examine the burden of acute malnutrition in this age group, investigate case management in emergency programmes, and assess guidance and tools available to inform programmers. Published findings highlighted a high burden of wasting in infants under six months globally, and higher mortality in this age group in emergency programmes. 

MAMI Special Interest Group (MAMI SIG) was formed, coordinated by ENN, to help address the gaps in guidance and evidence. This group now comprises 36+ practitioners and researchers involved in MAMI policy, research and programming worldwide, and works to harmonise and collaborate on policy, research & programming.

This project is founded on very strong partnerships with creative, intuitive, pragmatic academics and direct engagement with programmers working with these infants. ENN collaborates closely with leads at the London School of Hygiene and Tropical Medicine (LSHTM) Marko Kerac) and Save the Children US, in addition to researchers at the KEMRI-Wellcome Trust Project (Kenya); NGOs including Save the Children, GOAL, ACF, MSF, World Vision and Partners in Health; UN agencies (UNICEF, WHO, UNHCR, WFP) and independent experts and practitioners.

Project summary

The MAMI SIG has been successful to date in: 

ENN is a member of the Council of Research and Technical Advice on Acute Malnutrition (CORTASAM) of the No Wasted Lives Initiative, representing a MAMI interest. 

ENN is technical advisor on MAMI research led by Save the Children in Bangladesh to investigate the burden of acute malnutrition in infants under six months and explore perceptions of caregivers and health workers regarding community based treatment options (submitted for peer review publication). A new phase in 2018 is piloting the C-MAMI tool in Bangladesh.

To help support progammers, ENN’s online technical forum, en-net, includes a MAMI thematic area

MAMI SIG Meetings 

On 17th January 2018, ENN hosted a meeting of the MAMI SIG in Oxford, funded by Irish Aid and Save the Children. The MAMI meeting report is available here. This immediately followed a combined meeting of the MAMI SIG and Wasting and Stunting Technical Interest Group on the 16th January, to identify synergies. The MAMI WaSt meeting report is available here.

MAMI SIG meeting report, January 2016

MAMI SIG meeing report, January 2018

MAMI WaSt meeting report, January 2018

MAMI research, reviews and resources

Current and recent research and reviews include:

C-MAMI tool - This is a short practical tool to support community-based management of uncomplicated cases of acute malnutrition in infants under six months of age (C-MAMI) that was  developed by ENN, LSHTM, Save the Children US and collaborators in 2015. The aim was to provide a first step to case mangement to catalyse programming development, modelled on the Integrated Management of Childhood Illness (IMCI) framework. Version 1.0 of the tool and a brief checklist is available here. Small scale pilots are underway in Bangladesh (Save the Children), Ethiopia (GOAL) and Rwanda (Partners in Health) with prospects in Kenya and Philippines mid-2018. 

A special section on MAMI featured in Field Exchange issue 58 (September, 2018) which included articles on the Rohingya response in Bangladesh, follow up of particularly vulnerable infants in Rwanda and news of the updated C-MAMI tool, among other articles. 

Peer reviewed publications

Kerac M, Frison S, Connell N, Page B, McGrath, M (2018). Informing the Management of Acute Malnutrition in Infants aged <6 months: risk factor analysis using nationally-representative Demographic

Islam MM, Arafat Y, Connell N, Mothabbir, McGrath M, Berkley JA, Ahmed T, Kerac M (2018). Prevalence, risk factors and outcomes of severe acute malnutrition among infants aged <6 months in Bangladesh: A prospective cohort study.

Perceptions of acute malnutrition and its management in infants under six months of age: a qualitative study in rural Bangladesh" in its current form for publication in Clinical Medicine Insights: Pediatrics. Accepted for publication (Feb 2018).

Kerac M, Blencowe H, Grijalva-Eternod C, et al Prevalence of wasting among under 6-month-old infants in developing countries and implications of new case definitions using WHO growth standards: a secondary data analysis. Archives of Disease in Childhood 2011;96:1008-1013.

Angood et al (2015) Research priorities to improve the management of acute malnutrition in infants aged less than six months (MAMI)

Grijalva-Eternod, C.S., Kerac, M., McGrath, M., Wikinson, C., Hirsch, J.C., Delchevalerie, P. and Seal, A.J. (2016) Admission profile and discharge outcomes for infants aged less than 6 months admitted to inpatient therapeutic care in 10 countries. A secondary data analysis. Matern Child Nutr. 2016 Jul 25, doi: 10.1111/mcn.12345. 

A review of methods to detect cases of severely malnourished infants less than 6 months for their admission into therapeutic care by ENN, 2017.The Childhood Acute Illness and Nutrition Network and LSHTM.  

Pending publication

Mwangome M, Moses Ngari M, Kerac M, Kabore P, PhD thesis author, Bawhere P, McGrath M and Berkley JA. Mid upper arm circumference at birth and at age of routine vaccination to predict mortality in the first year of life: a retrospective birth cohort study in Bukina Faso.  Being finalized for publication in 2018.

More like this

FEX: Updated C-MAMI Tool now available

The C-MAMI (Community Management of At risk Mothers and Infants under six months of age) Tool provides a health worker with a format to assess and manage at risk mothers and...

FEX: C-MAMI tool evaluation: Learnings from Bangladesh and Ethiopia

By Sarah Butler, Nicki Connell and Hatty Barthorp View this article as a pdf Sarah Butler is the Director of Emergency Nutrition at Save the Children, USA. She has more than...

FEX: Management of At risk Mothers and Infants (MAMI) meeting

A one-day meeting of the Management of At risk Mothers and Infants (MAMI)1 Special Interest Group (SIG) took place in London on 17 January 2018. The meeting was hosted by ENN...

FEX: Piloting the C-MAMI approach in the Rohingya response in Bangladesh

By Anne Marie Kueter, Alice Burrell, Sarah Butler, Mostofa Sarwar and Habibur Rahaman View this article as a pdf Anne Marie is a nutritionist with over five years'...

FEX: Improving community management of uncomplicated acute malnutrition in infants under six months (C-MAMI): Developing a checklist version of the C-MAMI tool

Summary of MSc project report1 By Sonja Read Sonja Read is a public health nutritionist from the London School of Hygiene and Tropical Medicine. She has previously worked in...

FEX: MAMI Interest Group meeting

On 27th January 2016, ENN, London School of Hygiene and Tropical Medicine (LSHTM) and Save the Children co-hosted a one day meeting of a Management of Acute Malnutrition in...

FEX: Special Section on MAMI: Editorial

View this article as a pdf This issue of Field Exchange features six articles on managing nutritionally vulnerable infants under six months of age. This MAMI 1 section...

FEX: The cost of implementing the C-MAMI tool to treat nutritionally vulnerable infants in Bangladesh

By Natasha Lelijveld, Mostofa Sarwar, Golam Mothabbir, Sarah Butler and Nicki Connell View this article as a pdf Natasha Lelijveld is a Research Fellow at the Centre for...

FEX: Community management of uncomplicated malnourished infants under six months old: barriers to national policy change

By Sonja Read and Marie McGrath View this article as a pdf Sonja Read is a public health nutritionist and was lead researcher (ENN consultant) on the project. Marie McGrath...

NEX: Perceptions of severe acute malnutrition and its management in infants under six months of age: An exploratory study in Bangladesh

Yasir Arafat1is a medical doctor and public health practitioner, managing community-based nutrition programmes targeting acute malnutrition. He is currently working with Save...

FEX: Management of acute malnutrition in infants less than six months in a South Sudanese refugee population in Ethiopia

By Mary T Murphy, Kassahun Abebe, Sinead O'Mahony, Hatty Barthorp & Chris Andert View this article as a pdf Lisez cet article en français ici Sinead O'Mahony is a...

FEX: Making connections: Joint meeting of WaSt Technical Interest Group and MAMI Special Interest Group

ENN coordinates two international technical groups, the Management of at-risk Mothers and Infants under six months Special Interest Group (MAMI SIG) and the Wasting and...

Resource: C-MAMI Tool, Version 2 (2018)

The C-MAMI Tool provides a health worker with a format to assess, identify/classify and manage at risk mothers and infants under six months in the community (C-MAMI) who are...

FEX: Report on innovations in CMAM

By Anne Marie Kueter, Claudine Prudhon, Emily Keane and Megan Gayford The implementation of community-based management of acute malnutrition (CMAM) as the standard model of...

FEX: Methods to detect cases of severely malnourished infants under six months

Summary of research1 Location: Global What we know: The World Health Organization (WHO) recommends weight-for-length z score (WLZ) as an anthropometric indicator to identify...

FEX: Revised CMAM Training Guide

The Food and Nutrition Technical Assistance III Project (FANTA), in collaboration with partners (Action Against Hunger, Alliance for International Medical Action (ALIMA),...

FEX: Challenges in protecting non-breastfed infants in the Rohingya response in Bangladesh

Alice Burrell is a public health nutritionist with five years of experience working in the nutrition sector in multiple countries, mainly on infant and young child feeding in...

FEX: ENN led Management of Acute Malnutrition in Infants (MAMI) Project

A mother with her infants enrolled in Tahoua feeding centre in Niger, run by CONCERN and supported by WFP Funded by the UNICEF led Interagency Standing Committee (IASC)...

Resource: Meeting Report: Management of At risk Mothers and Infants under six months (MAMI) Special Interest Group (SIG) meeting

A one-day meeting of the Management of At risk Mothers and Infants under six months (MAMI) Special Interest Group (SIG) was hosted by ENN in collaboration with the London...

FEX: Risk factors for severe acute malnutrition in infants <6 months old in semi-urban Bangladesh: A prospective cohort study to inform future assessment/treatment tools

Summary of conference abstract1 Presented at the ACF research conference, November 9th, 2016. By M Munirul Islam, Yasir Arafat, Nicki Connell, Golam Mothabbir, Marie...

Close

Reference this page

Marie McGrath (2016). Management of At Risk Mothers and Infants (MAMI). www.ennonline.net/ourwork/research/mami

(ENN_1026)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.