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Improving nutrition programmes through the promotion of quality coverage assessment tools, capacity building and information sharing.

Can coverage methods be used to give an estimate of MAM coverage? What are the realistic assessment implications (time, staffing, resources) of piggy-backing MAM coverage to a survey for coverage of SAM?

SQUEAC is a method designed to assess selective therapeutic feeding services i.e. services with defined criteria of selection or eligibility in order to benefit from the service. For outpatient and inpatient therapeutic care, generally, this eligibility is quite clear cut and applicable across the board. Often there is high variance in the forms of SFP being implemented (blanket, targeted, alternating blanket and target, protection rations etc.). Determining who should be eligible for it is not clear cut, which makes sampling very complicated. In general there is very little value in assessing SFP coverage unless the service uses very clear eligibility criteria. Should SFP coverage assessment be found to be critical and valuable, then adding SFP coverage onto SQUEAC is quite straightforward, but will potentially require some additional resources in terms of either time or staffing to complete. If management of MAM is by set criteria e.g. SFP for children aged 6 - 59 months who have MUAC < 125 and ≥ 115, then if we are to assess coverage of both SFP and outpatient therapeutic care in one survey, the implications will be as follows: In summary, the technical difference lies in the use of a census approach rather than active and adaptive case-finding, which may impact on the time and/or resources required for a wide-area survey. Source: Guevarra E, Norris A, Guerrero S and Myatt M, Assessment of Coverage of Community-based Management of Acute Malnutrition, CMAM Forum Technical Brief July 2012, Version 2: September 2014. Accessible online here.