A ‘booster’ is anything that encourages or enables access to a program or leads to an increase in coverage. Factors commonly identified as having a positive effect on coverage include:

• Active and regular case finding by motivated volunteers
• Good knowledge and understanding of the programme by the local population
• Key community figures actively support the programme
• Effective systems in place for referral, transfer and follow up of cases
• Good relationships between CMAM actors and adequate support and supervision given to volunteers, health centre staff, and program personnel
• Good and continued supply of RUTF.

A ‘barrier’, also known as a ‘bottleneck’ (Tanahashi 1978), is anything that restrains, obstructs, or delays access to a program or restrains coverage. Factors frequently identified as having a negative effect on coverage include:

• Lack of knowledge of the program
• Lack of awareness of malnutrition or mismatch between program definition and community understanding
• Distance to program site
• Previous rejection by health centre staff
• Limited active case finding / few or demotivated volunteers
• Service-related problems (especially RUTF out of stock)

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.