CMN Cube Looking LogoCoverage Monitoring Network

CMAM COVERAGE MONITORING

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

Which methodology to choose?

Coverage assessment methodologies are adaptable. Depending on the information which programme staff would like as an output of their assessment, there are a choice of five possible assessment methodologies.

MEASURING COVERAGE & BARRIERS

Specific assessment methods have been developed to measure coverage and provide information on barriers to coverage:

 SQUEAC
The SQUEAC method is a comprehensive, iterative tool to analyse the barriers and boosters to coverage and give an estimate of coverage. It is also provides succinct actions for improving access and coverage
SLEAC
The SLEAC method is a method designed to give rapid information on the spatial representation of coverage. It was developed for measuring coverage at the Regional level
Follow up SQUEAC
If a coverage assessment has taken place, much of the necessary information is already available. Follow-up should be carried out in order to assess the impact of remedial activities
Outputs•Coverage estimate %
•Community profile
•Barrier information
•Action plan
•Coverage classification / estimate
•Barrier information
•Updated barrier information
•Coverage estimate %
Data sources•Routine programme data
•Community members
•Health facility staff
•Case finding
•Case finding •Routine programme data •Community members
•Health facility staff
•Case finding
Resources£££ District level)
£££ Regional / National level
££
Timing21 days 5-7 days per district7-10 days
ScaleHealth DistrictRegional or NationalHealth District
Competencies•quantitative data monitoring and data analysis
•qualitative data collection / community assessment
•LQAS
•Bayes theory
•Geographic sampling •Report writing and action plan setting
•LQAS
•Geographic sampling •Report writing
•Qualitative data collection •Geographic sampling
•Report writing

With the exception of some elements of a SLEAC assessment, if an assessment team has previously conducted a SQUEAC assessment in full, they will be able to conduct all other coverage assessment methodologies. The SQUEAC / SLEAC technical reference is available to download here.

ASSESSING BARRIERS

Information on bottlenecks to coverage can be gained independently of coverage assessment methodologies through routine data analysis or qualitative data collection and analysis. Bottlenecks can appear at various levels of service provision, ranging across the four broad categories of enabling environment, supply, demand and quality. These categories are based on the Tanahashi model of coverage, which identifies the relationship between the target population and service achievement. Below are two methods for collecting this type of information.

 Routine Bottleneck Analysis
Collecting routine data as per the Tanahashi model of the determinants of coverage can help identify, in a structured and logical manner, bottlenecks to effective coverage. This analysis should be carried out on a regular basis using routine data and qualitative stakeholder discussion.
Community Assessment
Qualitative information is key to understanding the profile of the community, to understanding health seeking behaviour, communication channels. This activity fits within a SQUEAC assessment but can be carried out independently if a coverage estimate is not needed.
Outputs•Barrier Information
•Action Plan
•Community profile
•Barrier information
•Action plan
Data sources•Routine programme data •Community members
•Health facility staff
Resources£££
TimingHealth District – 1 day data collection per month + stakeholder consultations every 3 months
Regional / National – 1 -3 week data collection + stakeholder consultations every 6 months or year
5 days
ScaleHealth District, Regional or NationalHealth District
Competencies•Quantitative data collection and analysis •Qualitative data collection
•Report writing and Action plan setting

[For a printable and downloadable version of the tables above, please follow this link]