Severe acute malnutrition is defined by a very low weight for height (below -3z scores of the median WHO growth standards), by visible severe wasting, or by the presence of nutritional oedema. Decreasing child mortality and improving maternal health depend heavily on reducing malnutrition, which is responsible, directly or indirectly, for 35% of deaths among children under five.
Although the median under-five case-fatality rate for severe acute malnutrition typically ranges from 30% to 50%, it can be reduced substantially when physiological and metabolic changes are taken into account. Management of severe acute malnutrition according to WHO guidelines reduced the case-fatality rate by 55% in hospital settings and recent studies suggest that communities such as ready-to-use therapeutic foods, can be used to manage severe acute malnutrition in community settings. In order to train health workers in applying this scheme WHO has created a course which, with the aid of institutional partners in Bangladesh, Chile, Gambia, Malawi and the UK, has been conducted in countries in the African, South-East Asia and Western Pacific Regions.