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Applying WHO Prioritization Criteria for Moderate Wasting: Programmatic Implications.

Isabel Potani1,2, Zachary Tausanovitch1, Grace Heymsfield1

  • 1International Rescue Committee, New York, New York, USA.

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|December 7, 2025
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Summary
This summary is machine-generated.

Most moderately wasted children met prioritization criteria, yet recovery rates were similar between higher and lower priority groups receiving special foods. Further research is needed to assess intervention impacts.

Keywords:
combined protocolmid‐upper‐arm circumferencemoderate wastingready‐to‐use therapeutic foodsimplifiedspecially formulated food

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Area of Science:

  • Public Health
  • Pediatrics
  • Nutrition Science

Background:

  • The World Health Organization (WHO) 2023 guidelines recommend prioritizing children for specially formulated foods (SFF) in managing moderate wasting.
  • The practical implications and effectiveness of this prioritization strategy in real-world programs remain unclear.

Purpose of the Study:

  • To analyze caseload and treatment outcomes for moderately wasted children (6-59 months) in Mali, comparing higher-priority (HP) and lower-priority (LP) groups.
  • To evaluate the feasibility and rationale of WHO's prioritization criteria for SFF distribution.

Main Methods:

  • Secondary analysis of 35,685 Malian children with moderate wasting (MUAC 115-<125 mm) treated with SFF.
  • Children were categorized into HP and LP groups based on age, WAZ (<-3 SD), and MUAC (115-119 mm vs. >=120 mm).
  • Treatment outcomes including recovery rates and anthropometric changes (MUAC-for-age z-score, WAZ) were compared between groups.

Main Results:

  • Nearly all (95%) moderately wasted children met at least one prioritization criterion.
  • Recovery proportions were similar between HP and LP children, irrespective of the specific criterion used.
  • MUAC-for-age z-score and WAZ trajectories showed comparable weekly changes between priority groups, though older LP children had lower WAZ.

Conclusions:

  • The current prioritization criteria may not effectively differentiate children needing SFF, as most meet the criteria.
  • Similar treatment outcomes suggest that the prioritization approach may warrant re-evaluation.
  • Further research is essential to determine the impact of different intervention strategies for moderate wasting.