Only 15 percent of the Senegalese children expected to suffer from severe malnutrition by the end of the year have been treated by the government so far, because of poor screening and weak links between detection and treatment, according to the U.N. Children's Fund (UNICEF).
Despite a UNICEF prediction that more than 63,000 children under the age of five are likely to suffer from severe acute malnutrition (SAM) by the end of 2013, the government has treated only 9,341 children so far this year, the latest Senegal Situation Report (pdf) says.
The biggest problem is the economic and social barriers that make it hard to get parents and children through the door at the health facilities, said Xavier Crespin, head of child health at the UNICEF Senegal country office.
"Many people live far from the health centres. When their cases are identified, they get a ticket for free health care, but they don't have the means to get to the health facilities or to stay there overnight," Crespin said.
"People are ashamed of not being able to feed their child so they don't like turning up to health facilities. However, nutrition isn't just linked to eating properly, but to disease, to hygiene, to breastfeeding," he said.
Senegal was severely hit by the West Africa Food Crisis of 2012, which at its peak left over 18 million people food insecure throughout the Sahel. Tackling malnutrition was one of the first pledges made by President Macky Sall's government when it came to power in June last year.
In 2013, the government set out to treat 42,843 children in accordance with the SPHERE standards, a charter for minimum standards in humanitarian responses. It is considered unlikely to meet this target.
"It is positive that the problem of malnutrition is no longer being neglected and is starting to be addressed despite real challenges. But at this pace targets for 2013 will indeed not be met, which is sad because children who are left untreated for SAM stand a 50% chance of dying," said Sophie Battas, from the European Commission's humanitarian aid service ECHO.
The poor screening capacity of the Cell to Fight Malnutrition (CLM), the national organisation responsible for the identification of malnutrition cases, has also played a major role in the low level of treatment, Crespin said.
Despite doubling in size between 2006 and 2013, the CLM covers only 50 percent of the affected areas, he said.
"We know how to screen for malnutrition, we have the experience, but the government are not engaging on the topic of malnutrition and we simply can't get the resources to expand and fully cover the affected regions, Marieme Diaw, nutritional adviser at CLM, told Thomson Reuters Foundation.
UNICEF, which partly funds CLM, has managed to get only 53 percent of the funding required to run the malnutrition response effectively.
But the biggest challenge is planning, coordination and investment in long-term solutions among the international aid agencies, Diaw said.
"Traditional aid partners like UNICEF and WFP give hundreds of millions of CFA, but there's no inter-agency coordination or vision between them, it's just a short-term fix focused on the worst affected zones," said Diaw.
"Only when you have a coordinated and fully planned programme over a longer term can you expect to make any real impact," she added.