The primary objective of this evaluation was to assess the performance and level of integration of a Community-based Management of Acute Malnutrition (CMAM) pilot programme. The evaluation focused on three main areas: (1) the national CMAM pilot strategy designed to guide and support the implementation of each pilot programme, (2) the Bardiya pilot programme itself, and (3) the lessons learned from the Bardiya experience and its implications for future CMAM services nationwide. The evaluation examined three assumptions: that CMAM would reduce barriers to treatment and increase coverage from 1 per cent to 50 per cent; that it could be sustained in the regular health services; and that it could create capacity for effective treatment of severely malnourished children.