A review of coverage data from programmes treating severe acute malnutrition (SAM) collected between July 2012 and June 2013 has been published online by PLOS One. The descriptive study, written by members of the CMN, Brixton Health and ACF, explores the coverage levels and barriers to coverage recorded in 44 assessments across 21 countries. The programmes included in the study were largely from sub-Saharan Africa and covered camp, urban and rural settings.

Figure 1  

The study showed that most of the programmes (33 of 44) failed to meet Sphere standards for coverage with the mean level of estimated coverage achieved by the programmes being 38.3%. When disaggregated by setting only programmes in rural areas were able to exceed Sphere standards, which at 50% is the lowest threshold of all settings.


The most frequently reported barriers to access were lack of awareness of malnutrition, lack of awareness of the programme, high opportunity costs, inter-programme interface problems, and previous rejection. Figure 2

The main conclusion of the study is that coverage of SAM programmes is now lower than that found in previous analyses of early Community Therapeutic Care (CTC) programmes; which means that programme impact is reduced. Based on the evidence of the barriers, the most appropriate way to address this issue is to pay greater attention to specific activities such as community sensitisation and satellite sites. Crucially, the barriers are interconnected so a well-chosen action is likely to increase utilisation of services significantly as it will address more than one barrier.

To successfully increase coverage and sustain that improvement, programmes are advised to continuously monitor barriers and maintain responsive to programme changes to ensure their timely removal.

  - The full article is available¬†here!