Coverage of treatment for acute malnutrition among children aged 6–59 months in Ethiopia: a community-based representative survey

Abstract

The Integrated Management of Acute Malnutrition (IMAM) program was introduced to strengthen the continuum of care for children with acute malnutrition and improve early detection and treatment. However, evidence on the effect of IMAM implementation on treatment coverage and related program outcomes remains limited. This study aimed to estimate treatment coverage for acute malnutrition among children aged 6–59 months in Ethiopia, compare treatment coverage between districts implementing the IMAM program and those without IMAM implementation, and assess the independent association between IMAM program implementation and treatment coverage. A community-based comparative cross-sectional study was conducted from June 2023 to July 2023. A multistage cluster sampling technique was employed to select a total of 1,440 children aged 6–59 months from 12 districts in Ethiopia, of which six were implementing the Integrated Management of Acute Malnutrition (IMAM) program and six were non-IMAM districts. Treatment coverage was estimated as the proportion of children with acute malnutrition identified in the survey that received or were enrolled in appropriate treatment services during the six months preceding the survey. The overall treatment coverage during the six months preceding the survey was 56.9% (95% CI: 52.0–61.7). Treatment coverage was significantly higher in IMAM-implementing districts compared with non-IMAM districts among children with moderate acute malnutrition (68.9% vs. 39.0%, P < 0.001) and severe acute malnutrition (68.6% vs. 35.9%, P < 0.001). In multivariable logistic regression analysis, children residing in IMAM-implementing districts had significantly higher odds of receiving treatment compared with those in non-IMAM districts (AOR = 3.19, 95% CI: 1.53–6.64; P < 0.001). Treatment coverage for acute malnutrition remains suboptimal in Ethiopia, with marked differences between IMAM-implementing and non-IMAM districts. IMAM implementation resulted in significantly higher treatment coverage among children.