Estimating the number of deaths averted from 2008 to 2020 within the Ethiopian CMAM programme

• Published in: Maternal and child nutrition 2024-07, Vol.20 (S5), p.e13349-n/a
• Main Authors: Laillou, Arnaud, Baye, Kaleab, Guerrero Oteyza, Saul I., Abebe, Frezer, Daniel, Tewoldeberha, Getahun, Banchiliyew, Chitekwe, Stanley
• Format: Article
• Language: English
• Subjects: Averages; averted death; Children; Children & youth; Cost analysis; Costs; cost‐effective; Death & dying; Estimates; Fatalities; Funding; Malnutrition; Mortality; Nutrition; prevention; treatment; wasting
• ISSN: 1740-8695; 1740-8709; 1740-8709
• DOI: 10.1111/mcn.13349

The management of wasting in Ethiopia is heavily reliant on the Community‐based Management of Acute Malnutrition (CMAM) programme that has been implemented in more than 18,000 service delivery points scattered across the country. Despite the full‐scale implementation of the CMAM, the number of child death averted, and the cost per child death averted remains unknown. This study aimed to estimate the cost and the number of child death averted by the CMAM programme between 2008 and 2020. Using data from routine monitoring of the CMAM programme, we estimated the excess mortality averted by the programme and estimated the cost per averted child death based on supply and labour. Over the past 13 years between 2008 and 2020, 3.6 million children under 5 years were admitted to the Ethiopian CMAM programme. The yearly average admission of 317,228 was achieved since 2011. On average, ~34,000 child deaths were averted yearly. The CMAM programme was estimated to have saved 437,654 (95% confidence interval [CI]: 320,161; 469,932) child deaths between 2008 and 2020, approximately 12% of the admitted cases. The average cost of the programme per adverted death was estimated at US$762/child death averted (95% CI = 639; 1001). The CMAM programme in Ethiopia is cost‐effective and has continued to avert a significant number of child death. Given the high short‐ and long‐term economic and health consequences of child wasting, concerted multi‐sectoral efforts are needed to accelerate progress not only in its treatment but also in its prevention. Following a 95% confidence interval, the estimate is that between 320,161 and 469,932 children were saved from death. Key messages A total of 3.6 million children were admitted between 2008 and 2020, increasing annually from 92,000 in 2008 to 390,000 in 2020 due to improvement in case findings and referral. Death rate in Community‐based Management of Acute Malnutrition (CMAM) programmes has decreased by sixfold between 2008 and 2020 from 1.23% to 0.22% During 13 years of implementation, the Ethiopian CMAM programme averted the death of >400 thousand children under five.