In Senegal, we witnessed a quiet but potentially game-changing shift - one that could significantly improve the way child acute malnutrition is tackled across the country, and perhaps beyond.

Like many countries in the Sahel, Senegal faces a high burden of acute malnutrition. Roughly 10% of children under five in Senegal are affected by this life-threatening condition, but only one in four are able to access treatment when and where they need it. The challenge of reaching children in remote or underserved areas has long limited progress.

In a major policy breakthrough, Senegal updated its National Protocol for the Prevention and Management of Acute Malnutrition to integrate community health worker (CHW)-led management of acute malnutrition without complications at national scale. These updates leverage strong evidence from a recent operational pilot in five regions, which demonstrated Senegal’s ability to achieve up to approximately 70% treatment coverage when CHWs are empowered to deliver treatment at the local level (villages and health huts). Through a new model called Unité de Réhabilitation Nutritionnelle à base Communautaire (UREN-C) approach, Senegal is poised to facilitate treatment at scale like never before.

Turning Global Guidance into National Action

Senegal’s shift builds on global guidance from the World Health Organization (WHO), which in 2023 recommended, for the first time, that:

"Assessment, classification and management or referral of infants and children 6–59 months of age with wasting and/or nutritional oedema can be carried out by community health workers as long as they receive adequate training, and regular supervision of their work is built into service delivery."

While this recommendation represents important progress in global normative guidance (which we spoke about previously here), many countries are still considering how (or if) they will operationalize this approach in their own contexts. Senegal is among the first to propose a clear pathway for policy integration at national scale.

Senegal is also among the first to take on the challenge of implementing CHW-led treatment for ‘high-risk’ moderate acute malnutrition (MAM), which will involve child-level screening for individual and social risk factors, as well as prioritization of specially formulated foods to those children at highest risk of nutritional deterioration. While the scale of this task is ambitious, it is also a source of optimism. With the right support and a clear structure, Senegal’s community health workers are well-positioned to navigate this complexity, demonstrate how CHW-led delivery can extend into care for high-risk MAM, and deliver life-saving care to more children, closer to home.

This is not a change that just happens overnight. Senegal’s ability to leverage CHW-led treatment through the UREN-C reflects years of steady, incremental investment in CHW capacity, skills and health systems integration. It is this strong foundation that now positions the country to act on evidence-based global guidance in a concrete and scalable way.

A National Commitment to Coverage

This bold move is aligned with Senegal’s broader nutrition goals. At the most recent 2025 Nutrition for Growth (N4G) Summit in Paris, Senegal made a public commitment to reach at least 80% of children under five with essential nutrition services by 2030, including boosting coverage of acute malnutrition treatment through early detection, community engagement, and expanded service delivery.

These priorities are being advanced under the leadership of the Ministry of Health and Social Action, through the Directorate of Mother and Child Health, in partnership with local communities, technical partners like Helen Keller International, and funders like the Eleanor Crook Foundation (read more about ECF’s partnership with Helen Keller International and the Ministry of Health here).

Sustaining Progress: The Role of RUTF

While these advancements to local policy and practice on child acute malnutrition in Senegal are remarkable, sustained progress will also require uninterrupted access to essential medical supplies like ready-to-use therapeutic food (RUTF), the product required for treatment of severe acute malnutrition. Thanks in part to the country’s ability to leverage the Child Nutrition Fund’s (CNF) match fund, stakeholders in Senegal anticipate a stable RUTF pipeline through early 2026. Confidence in product availability and access over the next year will provide a critical buffer as the country works to rapidly expand care through the UREN-C approach and integrate the management of high-risk MAM. 

However, longer-term investments into the RUTF pipeline and integration of RUTF into the management system of the national pharmacy will be critical for maintaining this momentum. We need to meet increases in demand for products from the integration of high-risk MAM children and Community Health Worker-Led Management of Acute Malnutrition scale up. With humanitarian and development funding becoming more volatile, it is essential to stabilize and diversify financing for RUTF and other key nutrition commodities, ensuring that progress on paper is matched by real-world improvements in child survival.

Ultimately, Senegal is laying the groundwork for what the future of care for child acute malnutrition can look like: locally driven, community-led, and grounded in strong systems. As the updated acute malnutrition protocol moves toward validation, the country’s approach may well serve as a blueprint for others navigating how to turn global guidance into national action.

"Community health workers are close to families. Giving them the tools to treat acute malnutrition will help more children get care quickly."

— Maguette Beye, Program Director, Helen Keller International Senegal