This guidance is designed to present practical lessons learns by experts in the field, and to provide guidance on effective operational preparation and requirements. Due to the difference in size and scope between district level and national or regional assessments, preparatory and methodological steps must be tailored to the type of assessment. These distinctions are made clear below.
- Survey team
- Finance/ Budget
- Arrangements for CMN representatives
- Notification to interested parties
a/ Terms of Reference
A ToR document should be developed outlining the background of the program including justification for a coverage assessment as well as the objectives, condition and schedule, and expected outputs.
b/ Investigation Protocol
A detailed investigation protocol should be developed detailing the procedural method in the design and implementation of the assessment. Sections might include, but are not limited to, the following: context and justification; general and specific objectives; methodology; assessment period; target population; sampling procedure; data analysis; limitations; ethical considerations; budget.
The investigation protocol is often required for validation of the assessment by the Ministry of Health and the National Ethical Committee (if necessary).
c/ Programme Data
The SLEAC methodology relies on the availability of accurate and up to date program data. The following program data should be made available, in electronic format, at least two weeks before the assessment commences.
1) National, regional or district-level nutrition data
• All nutrition surveys conducted in the intervention zone (SMART, MICS, etc.)
2) Routine Program Data
• Number of OTP and SFP sites in the investigation area
• Monthly statistical data (i.e. admission, cure, death and defaulter rates, length of stay, MUAC at admission etc.)
3) Demographic data for the target area
• List of villages with population figures and the average percentage of children aged 6-59 months (<5 years) in the area
• In the absence of reliable village lists, census divisions like enumeration areas (EAs) can be used for sampling purposes.
d/ Area Maps
A map of the investigation zone is an essential requirement to conduct a SLEAC coverage assessment. For regional or national assessments, a detailed map of each administrative region is required. Ideally, the map will have the following specifications:
• 1:50,000 scale
• Indication of administrative divisions, village locations, roads and rivers
• If possible, the map should be printed on A0 or A1
If EAs are used for sampling, photocopies of individual EA maps are required to indicate the precise section, village or multiple villages that comprise the selected EA.
2. Survey Team:
It is important to decide in advance who and how many participants will carry out the assessment.
The team should comprise:
- Steering Committee: 2 to 3 delegates from the Ministry of Health who are available to help organize and supervise the assessment for its entire duration. Active implication of partner organizations involved in conducting other nutrition surveys like SMART will help facilitate the process.
- Technical Committee: 5 to 10 people from various national partner organizations associated with nutrition. The technical committee will be trained on the SLEAC methodology by the consultants(s) and will be implicated in the elaboration and submission of the investigation protocol.
- Investigation Team: 30 to 40 participants with experience in conducting surveys. It is a good idea to recruit surveyors that have worked on other national nutritional surveys like SMART or MCIS.
Please note that the number of participants will vary according to the size and scale and ideal duration of the assessment. For large national investigations, increasing the number of participants will reduce the duration.
3. Finance and Budget:
Costs for a SLEAC assessment are broken down into two parts:
a) Costs for the field work (host agency)
b) Costs for the consultant(s): for large-scale, national SLEAC assessments, a team of two consultants may be required for division of responsibility, supervision and tasks.
4. Arrangement for Consultants:
- An invitation letter for visa applications or any other arrangements to obtain a visa upon arrival
- Arrangements for internal flights to and from the capital, if needed
- Airport collection and drop-off
- Accommodation (secure and suitable for expatriates)
- Security briefing on arrival in the field
- Local SIM card for communication with the team
It is very difficult to estimate the duration of a SLEAC assessment; the timeframe depends entirely on the number of regions assessed, the size of each region and the travel distance between regions. For pilot national SLEAC assessments conducted for the first time, unforeseen challenges are to be expected during the preparatory stages.
Please note that all preparatory measures taken to elaborate and validate the investigation protocol before the arrival of the consultant(s) will significantly reduce the preparatory stage and help facilitate the assessment.
Generally, preparation and training can take about two weeks. From there, the general rule of thumb is 1 week per region. One to two days should be allocated to travel time between regions. Again, this is an extremely rough estimate and will vary according to the size of the region. The table below illustrates a typical schedule.
|1 to 2 weeks||1 to 2 weeks Preparatory Phase|
• Meeting with MoH
• Technical committee meeting, technical training and elaboration of the investigation protocol
• Budget validation
• Operational planning
• Ethical committee validation (if necessary)
|Base||Consultant(s) and lead agency
|1 week||Classroom Training and Field Exercises|
• Opening session including introductions and schedules
• Theoretical training of the SLEAC methodology (2 days)
|Base||Consultant(s) and lead agency
• MUAC standardization (1 day)
• Practical training in urban context (1 day)
• Practical training in rural context (2 days, to account for travel)
• Survey preparation
|Field||Consultant(s) and lead agency
|1 week per region||Field Data Collection and Analysis|
Active case finding and wide area surveys
|Field||Consultant(s) and lead agency
|1 - 2 days||Data analysis and survey debriefing in the capital||Base||Consultant(s) and lead agency
The following suggests, in detail, the practical provisions required for training, fieldwork and completion of a SLEAC assessment.
I. Vehicles & Transport
II. Training Venue & Work Facility
- The investigation team will require drivers and vehicles to be available full-time for a number of days (5 days for training plus 7 days per region for data collection) during fieldwork, depending on the geographical spread and conditions.
- Each vehicle must carry a first aid kit.
The investigation team will require a place for meetings and trainings. The training room needs to be large enough to accommodate the entire investigation team for group work, equipt with tables and chairs, and with electricity and a projector.
III. Logistic Materials
a) For training:
b) For field work per person:
- Flip chart
- Markers and pens
- Stapler and staples
- Masking tape
- Notepads for the participants
- Pencils, sharpeners and erasers
IV. Other Provisions:
- Clip board
- Plastic folder for loose papers
- Pen, pencil, sharpener and eraser
- MUAC band
- RUTF packets
- OTP/SFP referral slips
- Simple water should be made available for field work
- Lunch and coffee break for training days
7. Notification of Interested Parties:
As a courtesy, and in the interest of ensuring those targeted by the survey are available at the time of the visit, it is important to notify village chiefs, camp leaders or other key community figure of the survey’s intention.