Strengthening frontline skills to treat acute malnutrition

From 1 to 10 September 2026, health centre staff from Bolikhamxay Province participated in Integrated Management of Acute Malnutrition for Outpatient Care (IMAM-OPD) training sessions organised by the Provincial Health Department with support from the Local development programme, co-funded by the Grand Duchy of Luxembourg and Switzerland. The training aimed to strengthen the capacity of frontline health workers to identify, treat and monitor children affected by acute malnutrition closer to their communities.

Acute malnutrition remains a major child health challenge in the target villages of the Local development programme. To identify and treat affected children closer to home, training on IMAM-OPD is being rolled out to health centre staff across the programme’s target areas. The training aim to ensure that severely and moderately malnourished children identified through village screening are properly assessed, treated and followed up until recovery at health centres within their communities. It also strengthens the capacity of frontline health workers to deliver standardised nutrition services in line with national IMAM guidelines and to improve access to treatment for children living in remote communities.

The programme-wide plan is ambitious : 262 health workers from 130 health centres across 17 districts in 4 provinces (Bokeo, Vientiane Province, Bolikhamxay and Khammoune) will be trained. Delivered province by province, the training allows participants to apply what they learn to the needs of their own communities. The sessions began in Vientiane Province and followed in Bolikhamxay Province.

The first session was held from 1 to 3 September 2026 at Bolikhan District Hospital. It brought together 30 health workers, including 21 women, from health centres in Bolikhan and Viengthong districts.

The second session took place from 8 to 10 September 2026 at Khamkeut District Hospital, bringing together 32 health staff, including 24 women, from health centres in Khamkeut and Xaychamphone districts.

The sessions were facilitated by medical doctors from Bolikhamxay Provincial Hospital, together with representatives of the Provincial Nutrition Secretariat and the Provincial Health Department focal point for the Local development programme.

Over 3 days, participants worked through the national IMAM guidelines, learning how to assess and classify the nutritional status of children aged 6 to 59 months and manage severe and moderate acute malnutrition at outpatient level. The training also covered the assessment of infants under 6 months.

Practical sessions focused on anthropometric measurements, appetite testing and the calculation of doses of ready-to-use therapeutic food and routine medicines. Through case studies and practical exercises, participants practised admission, referral and discharge procedures before applying them in their own health facilities.

The training placed a strong focus on recording and reporting. Participants practised completing OPD treatment cards, referral forms and monitoring tools, compiling monthly case summaries and entering data into DHIS2 and iCapture. Reliable records help districts monitor recovery rates and identify children who may be lost to follow-up.

The sessions also covered infant and young child feeding counselling, growth monitoring and promotion, supply management, and prevention through community engagement.

To provide context for the training, the programme presented findings from recent nutrition assessments conducted in the Local development programme's target villages. This gave participants a clearer understanding of the nutrition challenges faced by the communities they serve.

On the final day, participants worked in district groups to develop action plans for their respective health centres.

The barriers they identified were familiar : low household income, parental labour migration, long distances to health facilities, food taboos during illness and after childbirth, and limited dietary diversity.

To address these barriers, participants committed to :

• providing nutrition education during monthly village outreach activities;
• conducting regular child screening and growth monitoring;
• conducting home follow-up visits;
• organising cooking demonstrations using locally available foods;
• working closely with village authorities and representatives of the Lao Women's Union.

The training is expected to improve the early detection and management of acute malnutrition, strengthen nutrition reporting systems and enhance coordination between community-level screening activities and health facilities. Ultimately, it aims to ensure that more children receive timely treatment and make a full recovery.

The roll-out continues in Khammouane Province before expanding to Bokeo in October 2026. By combining clinical skills, reliable reporting and community-level planning, health centre staff will be better equipped to treat acute malnutrition where families live, ensuring that more children are detected early, receive appropriate treatment and are supported throughout their recovery.

The Local development programme is co-financed by the Grand Duchy of Luxembourg and Switzerland, and jointly implemented by the Ministry of Finance of the Lao PDR (formerly the Ministry of Planning and Investment) and LuxDev, the Luxembourg Development Cooperation Agency.