# of children and women screened for acute malnutrition

This indicator counts the number of individuals screened for acute malnutrition by community outreach workers, by mobile units and in static Health and Nutrition facilities.

It is considered one of the core indicators for any Nutrition program as the nutritional screening is considered to be main entry point for program participants (clients) where teams would be able to identify cases and refer back to the available services, whether that requires an immediate intervention, or a community wide awareness raising on feeding practices. Therefore, it is generally used as an output indicator that provides unique number that can be used as a reach of the Nutrition programs in general (with the exception of adult males that are not screened).  

Calculation: This is a count of individuals screened for acute malnutrition by community outreach workers and/or by the facility personnel (Only new admissions should be counted in the calculation per project cycle to avoid double or triple counting).

Important note: We are aware that not every implementing office might have capacity to provide the unique reach or triangulate the data to identify the multiple counts of individuals. If this capacity is not present, one approach could be, particularly at community level is to compare the total with the population figures of that community, and make sure that the total reported figure of children and women is not higher than that. Even if you don't have the full picture in terms of disaggregation's of that community, simple population figures can be taken from the community leaders. This should be available with any implementing office.

Data Collection Method/Tool:  Routine monitoring/ screening, mass MUAC screening.
Data Source: Monitoring checklist/form, MUAC Screening tally sheets, MUAC Screening Register.

Who Collects: Community Outreach Workers, Volunteers, Nutrition and Health Personnel/s in Save the Children or Implementing Partners including MoH.
From Whom: Community health workers, Volunteers, Nurse, Midwife.

Frequency of Collection: Data will be collected on an ongoing/rolling/monthly basis. 
Frequency of Reporting: Data will be reported in the semi-annual report, annual report and final performance report.

How to count and aggregate: LOA values are the reported values at the end of the award counting only the unique number of individuals, without double counting, who were screened for malnutrition by community health workers and volunteers.
Baseline Value Info:  No baseline value is needed

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Screened:  Refers to children under five years and pregnant and breastfeeding women (PBW) measured by Mid-Upper Arm Circumference (MUAC) for malnutrition during community outreach work.  Bilateral pitting Oedema is also checked for children during the MUAC screening. This may be on a weekly, monthly, or some other frequency.
Community outreach worker: Any community-level health or nutrition worker or volunteer trained to conduct MUAC and Oedema screening alongside other community-based health and nutrition activities.

Important note: Nutritional screening done at the community/HH level is called active screening and at facility level called passive screening. Community level screening by the outreach nutrition volunteers often aims to be “exhaustive” and therefore decreases bias in the results. For this reason it better represents the proxy nutritional status (e.g. proxy GAM rate) of targeted individuals (e.g. Children, PBW) distributed across the targeted community. In contrast, facility level screening or passive screening targets children and women who are visiting health facilities for health and nutrition services (often times) and, therefore, includes a a relatively large cohort of sick and malnourished individuals. Nutrition programmes often keeps separate register/ tally for community level and facility level nutrition screening activities. Hence the nutritional screening indicator has two main sources of data (e.g. Community and Facility). It is recommended for MEAL systems to maintain disaggregation in the reporting to assist data interpretation.

If the implementing office does not have the capability to distinguish screening data captured in facility (passive screening) versus data captured through outreach / community screening (active screening), we suggest only reporting outreach / active screening data to avoid duplication. The reporting platform would have the two units as community and facility