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This is an observational longitudinal cohort study conducted in the tribal blocks of central-eastern India, which demonstrates the effect of a community based management programme on acute malnutrition among children less that three years of age. The results of the innovation whose main elements were child care through crèches, community, mobilization and systems strengthening to ensure better child feeding and caring practices and delivery of public health and nutrition services, suggest that such a medium term strategy using a participatory approach may be comparatively effective by current WHO guidelines and other known community based interventions in terms of mortality, cost, degree and pace of improvements.