Introduction
Global acute malnutrition (GAM) is a measure of nutrition status or extent of malnutrition, precisely in children aged between 6 and 59 months. GAM provides the health community with information regarding the percentage of all children in this age range, usually in a refugee population, affected by malnutrition. They are classified on their low weight-for-height status, systemic edema, or inflammation. GAM measures give an indication on the short-term or the most recent nutritional history of the affected children. The measure is extremely important to global health and nutrition experts for public welfare and updating economic health policies because the global status of children affected by acute malnutrition increases the risk of illness and death. Children of this age group are not only specifically vulnerable to malnutrition but are also at increased risk of mortality and comorbidity linked to poor nutritional status. GAM is a reliable indicator of public welfare, considering the overall food sources and the time-to-time nutrition situation of the general population.
What Is the Difference Between MUAC and GAM?
GAM is usually easily confused with other common measurements of acute malnutrition, such as the mid-upper arm circumference (MUAC). MUAC is commonly used to select individuals for nutrition programs and surveillance. However, the measurements do not provide a legal threshold for the severity of a situation at the population level. Though the MUAC is a reliable and rapid screening tool for selecting individuals who fall under this category and is commonly used for nutritional surveillance programs, it is not a global indicator. One cannot gain any formal threshold of the nutrition measurements in society by MUAC or other accessory nutritional surveillance programs. At a global level, it is only the GAM measurements that denote the public health status from a nutrition standard, and welfare measures are adopted accordingly by community and healthcare organizations and providers throughout the world.
What Are the Causes of Global Malnutrition?
After studying the GAM status, according to UNICEF (United Nations Children's Fund), a "food-first" focus is still the main reason for dominating global thinking. However, this needs to be more efficient and effective to prevent global malnourishment, especially in acute emergencies even today. Though specific strategies are being implemented in place and despite the increasing awareness of care for children and women, this "food first "strategy cannot prevent an individual from suffering from poor nutrition. It needs to be understood globally about the UNICEF framework.
The basic obstacles that can come in the way of global nourishment for young children are because of the following:
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War and conflicted local situations.
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Marginalization.
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Insecurity, inequalities, and poverty.
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Governance of natural resources.
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Migration and displacement.
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Gender discrimination.
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Livelihood systems.
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Long-term global trends that drive malnutrition.
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Seasonal food fluctuations cause acute malnutrition.
What Are the Unicef Guidelines for Managing Global Malnutrition?
According to the UNICEF framework, the following guidelines should be globally implemented by all countries, especially in the lower socioeconomic and middle economic countries, to counteract malnutrition trends:
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Treatment and prevention should go hand in hand, meaning that in all stages of a public malnutrition emergency, it is important to follow preventive health measures and health protocols.
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Nutrition-sensitive programs should be conducted based on partnership and localization.
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The root causes of persistent GAM are often linked to the wider political economy in a country. Hence this calls for a serious analysis to eliminate the crises.
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Research uptake and response analysis should be promoted in every country, highlighting the importance of public health and nutrition.
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Research agendas should be strengthened from time to time so that there is enough evidence to guide and conduct nutrition-based health programs and policies.
What Is Meant by Anthropometric Measurements?
The six anthropometric measurements are generally collected together for assessing GAM. These measurements are the standard that uses internationally recognized methods for assessing GAM. Then, the results are analyzed through specialized software like the ENA (emergency nutrition assessment) for SMART; SMART stands for specific, measurable, attainable, relevant, and time-bound.
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Sex: Male or female gender.
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Age: The individual's birth card or vaccination card for the date of birth is checked, and then age is verified or assessed by the calendar or verbal report of the mother.
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Weight: This is measured in kilograms (kg), usually accurately upto to the nearest 0.1-kg measurement. The reliable method is by using an electronic weighing scale.
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Length: Length is the third measurement measured in centimeters (cm) approximately to the nearest 0.1cm. They can be measured with wooden height boards provided by UNICEF with the necessary specifications. There are two measures further in measuring either length or height. Length is when the child is lying down (horizontally) and is measured for children under two years of age.
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Height: This is when the child is vertically measured standing up and is used for children above two years of age.
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Mid-upper arm circumference (MUAC)
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Presence of Nutritional Edema: Systemic or inflammatory swelling associated with malnutrition
What Are the Phases of GAM?
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Phase 1 (acceptable status) – GAM is for less than 5 percent of children who suffer from acute malnutrition.
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Phase 2 (alert status ) – GAM is between 5 to 9.9 percent of children who are acutely malnourished.
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Phase 3 (serious status ) – GAM is between 10 to 14.9 percent of children who are acutely malnourished.
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Phase 4 (critical status) – GAM is nearly in between 15 to 29 percent of children who are acutely malnourished, which contributes to elevated or increasing global mortality and morbidity levels. Even an individual's food consumption is severely compromised in this population.
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Phase 5 (extremely critical status) – When the GAM is 30 percent or more, the children are acutely malnourished and predisposed to systemic diseases and mortality. There is widespread morbidity with large individual food consumption gaps.
Conclusion
To conclude thus, despite various global efforts from countries, public welfare organizations and communities, and humanitarian intervention, there is still widespread scale, long-lasting and persistent GAM that indicates that nutrition and public health need constant upgradation, reformation, and positive societal changes in terms of policy and programming priority.
