There is a difference in perception about the meaning of our statement: "At the time of conduct of the study, there was no special provision or programme for management of SAM in Uttar Pradesh." We specifically refer to the original or a locally adapted version of the community management of acute malnutrition program, which among several other components includes routine recording of mid upper arm circumference and/or length or height to determine the weight-for-height status, classification as complicated or uncomplicated severe acute malnutrition and institution of specially formulated therapeutic foods till recovery occurs [1]. Obviously, the Bal Swasthya Poshan Mah (BSPM) program referred to is different in scope and cannot be equated with the community management of acute malnutrition program.

Our study design did not permit any causal inferences. However, we too had postulated that "improvement in access to public and private healthcare", which would include Public Health programs like BSPM, may have contributed to the low case fatality rates in children with severe wasting. If indeed this is true, the case for instituting a specific community management of acute malnutrition program is further weakened.