Completing a coverage assessment such a SQUEAC is known to be a valuable and effective tool for CMAM programmes to rapidly identify areas for improvement, increase programme performance and ultimately, save more lives. This page is designed to present guidance, based on many previous experiences, of essential steps needs to plan a SQUEAC (including a Community Assessment).
The preparatory phase of a SQUEAC investigation sets into motion all support mechanisms allowing for the smooth implementation of an assessment. It should start four weeks before the start of the assessment to ensure that all preparatory steps are launched and completed before the start of the assessment.
Click on the "Contents" tab to read about the steps to take to prepare for a SQUEAC. Alternatively, click here to download and print a PDF summary.
A Terms of Reference (ToR) should be developed outlining the background of the programme, including justification for a coverage assessment as well as the assessment’s objectives, conditions and schedule of work, as well as all expected outputs. For an example of ToR, please click here. In some countries the ToR needs to be validated by state authorities before the onset of the investigation. Therefore, in these cases, it is necessary to prepare the ToR well in advance of the anticipated start date.
A map of the working area is an essential requirement to conduct a coverage assessment. Ideally, the map will have the following specifications:
If a detailed map is not available, the team should draw one at the start of the investigation. This can be done by projecting a map onto a wall, tracing the map out on flipcharts and then adding health centres, towns, villages and main roads to the map.
The SQUEAC methodology relies on the availability of accurate and up-to-date programme data. The following programme data should be made available, in electronic format, at least two weeks before the assessment commences:
If the lead investigators are unfamiliar with the area and communities to be surveyed, they should obtain and read as many of the following documents as possible:
They should also familiarise themselves with the community and map out existing community actors (i.e. community (opinion) leaders, health committees, CBOs, etc), list their initiatives and/or activities, target populations and coverage. They should pay special attention to activities with a health focus, identify potential strengths and weaknesses of these actors, if involved in CMAM community outreach and gather suggestions on the most appropriate groups and networks to carry out CMAM
community outreach activities.
Carrying out a SQUEAC assessment requires a team of supervisors, enumerators and community mobilisation specialists (if any are available). Team selection should take place well in advance of the start of the assessment.
The team should comprise:
It is recommended that individual team members have a good understanding of the geographical, sociocultural and linguistic context of the area in which the study will be carried out. An experience with the implementation of surveys, such as SMART, KAP-B, RSCA or VCA, is an additional bonus. Special attention should be paid to the gender balance within the team, assuring a representation of women of at least 30%, aiming for 50%, if circumstances allow. The participation of community members and/or health district representatives will not only enrich the collection of data and the interpretation of results but it will also allow for a live transfer of competencies and spur follow-up actions within each party’s limits.
The success of a SQUEAC investigation is directly proportional to the depth and quality of the training provided to a SQUEAC investigation team.
Once recruited, the participants should be trained during the first two days of the SQUEAC assessment on the following topics:
Training packages (including schedules, presentations and key messages) are available in the Capacity Building section.
Costs for a coverage assessment vary according to the location. However a sample budget can be downloaded here.
Generally, the training and coverage survey take 10 to 20 working days, depending on conditions and the methodology used to conduct the survey. Below illustrates a typical schedule:
|Day 1||Travel to programme base|
|Day 2 - 3||Classroom training & field exercises: Classroom training: Opening session, including introductions and schedules; Methodology review; Distribution of tasks to the assessment team; Collection of some contextual data from the field; Analysis of Quantitative Data|
|Day 4 - 8||Stage One: Field data collection and analysis: OTP data collection for additional data; Contextual data analysis (qualitative); Identification of potential barriers and boosters of coverage; Mindmaps|
|Day 9||Data analysis in classroom: Preparation for Small Area Survey|
|Day 10 - 12||Stage Two: Field data collection: Conduct Small Area Survey in communities with active case findings|
|Day 13 - 14||Data analysis in classroom: Preparation for Wide Area Survey|
|Day 15 - 18||Stage Three: Field data collection: Conducting Wide Area Survey|
|Day 19 - 20||Data compilation of wide area survey: Estimations of coverage; Recommendations; Action plan|
|Day 21||Travel back to departure city|
An example of a SQUEAC agenda can be found here in PDF. An excel version is available here.
The following recommends, in detail, the practical provisions required for training, fieldwork and completion of a coverage assessment